CLINICAL VARIETIES 



291 



TREATMENT. 



Rest, especially during- the acute phases. 



Cleanliness. Avoid minor injuries. Massage. 



Exercise the enlarged glands. 



The removal of the mass has a mortality of 5 per cent. The opera- 

 tion is carried out as follows : — 



Put the patient to bed for at least two days, clean the skin carefully, 

 suspend the mass in order to drain it. Place a figure of eight elastic 



Elephantiasis. Breast. West Coast of Africa. 



bandage around the pelvis and the neck of the tumour. Select good 

 skin for the flaps if possible. Turn the tumour upwards and incise for 

 flaps in front of the anus. Then cut out the anterior flaps from the 

 pubes downwards in the mid-line, ligaturing the vessels as required. 

 Cut down the penile canal with scissors and dissect out the testicles 

 and penis. Pass a catheter as soon as possible; it will serve as a guide 

 to the urethra and penis. Dissect out and separate the mass, loosen 

 the tourniquet, and ligature any vessels. Puncture or otherwise open 

 all hydroceles, invert the sac, remove the redundant tissue, and stitch 



