ABLATION OF TUMORS. 205 



{(I) With the Thermo- Cautery. — The ablation of tumors can 

 also be performed with the flat i^latinum cautery of Paquelin, 

 well heated, by following the same rules as with the bistoury, 

 both when either the growths are small, or the incision of the skin 

 and dissections of the tumor have been previously performed. 

 The advantages gained by the use of the red-heated cautery in 

 controlling the hemorrhage while the incision goes on, is too ob- 

 vious and important to be ignored or depreciated. 



2d. — Ligature. 



The ligatiu'e operates on the tumor in its o^vn peculiar and 

 effective way, by circumscribing the base and deiDriving it of its 

 nutriment by occluding the circulation and leaving it to undergo 

 the process of gangrenous dissolution and sloughing, with the ad- 

 vantage of obviating any apprehended danger of subsequent hem- 

 orrhage. The kind of ligatures used for this purpose will vary 

 with the choice of the practitioner. In veterinary surgery, the 

 material is variously flax, hemp, silk, catgut, india rubber cords, or 

 metaUic wire. Whipcord or fishing line is often used, when a 

 powerfvd constriction is to be apj)lied, and their efficiency is in- 

 creased by being waxed or soaped. There are various ways of 

 aj)plying a ligature, but they are all subject to the following rules: 

 the size of the ligature must be proportioned to that of the parts 

 to be Hgated, and to their resistance ; it ought to be ajiplied only 

 upon a Hniited portion of the tissues, and the skin ought never to 

 be included, except when the peduncle is very narrow, or the skin 

 already ulcerated. 



Mrst Method, Simple Ligature. — A cord or band is affixed 

 around the base of the tumor, and tightly tied by a single knot. 

 Sometimes the bleeding knot or double clove-hitch is preferred, 

 drawn tightly and secured by a simple knot. 



The mortification of the growth may be accelerated, if thought 

 proper, by covering the ligature with some caustic jDreparation, 

 such as an ointment of sulphide of arsenic, or also by adding to 

 the effect of the hgature that of the actual cautery. 



Second Method, Double Ligature. — This is 

 brought into requisition when the peduncle of the 

 tumor is too large to be easily embraced by a sin- 

 gle ligature. It is made by i)iercing the l^ase of the j,j^_ ssa-Tapeetry 

 growth thi-ough the centre, by means of a straight Ligature. 



