124 MALIGNANT TUMOURS. 



the enlarged cord ; and then carefully dissect away the skin until 

 it is entirely separated from the tumour. Although it is advisable 

 to do this as much as possible with the fingers (for torn blood- 

 vessels will not bleed as freely as clean-cut ones) ; we can make 

 but little progress in well-developed cases without a free use of the 

 knife. We should, however, when employing it, carefully note the 

 position of the many newly-formed veins, which manifest them- 

 selves by their blue colour, and which we should ligature before 

 cutting through them on the tumour side of the ligature. The 

 tying of one of these veins may be perfonned by passing underneath 

 it a curved suture needle, through which a piece of silk or stout 

 thread has been threaded, and tightly closing the vein by a reef 

 knot (Fig. 32, p. 73). While this dissection is taking place, the 

 operator should have an assistant to instantly remove the blood 

 from the exjoosed surface by pressing on it for a moment a sponge 

 out of which moisture has been squeezed. The assistant should 

 have two sponges to use by turns, and a pail of water in which to 



Fig. 44. — Torsion forceps. 



clean them. The operator should have at hand an artery forceps 

 to pick up, and twist if necessary, any blood-vessels which he may 

 inadvertently cut before ligaturing them. Owing to the fact of 

 these veins having a large calibre compared to the thickness of 

 their walls, ligaturing will be more effective for closing them than 

 twisting. 



Wlien the tumour is thoroughly free from the previously adhering 

 scrotum, we may take it in our hands and twist it round and round, 

 until the cord gives way. To complete the severance, we may use 

 a torsion forceps (Fig. 44). After the tumour has been removed, 

 we should freely apply to the part, by means of a syringe, a suitable 

 antiseptic solution (p. 67) such as one of carbolic acid or creolin 

 in water (1 to 20). Our subsequent treatment will be similar to 

 that after castration. 



Nocard has had great success in the treatment of scirrhous cord 

 by the daily administration of 2^ drachms of iodide of potassium, 

 which amount may be largely increased (p. 127). By using J oz. 

 a day of iodide of potassium without any other means, I have had 

 entire success in the treatment of scirrhous cord. Some authori- 



