336 SEROUS CYSTS. 



lies down, his heel will not be able to touch his elbow. The Offord 

 and other elbow pads are effective appliances for accomplishing 

 this object. In Russia, an arrangement similar to the Offord pad 

 is used with those match trotters which are liable to hit their 

 elbows. It is well to use gentle massage (p. 664) and continued 

 fomentations of warm water for a few days, and after that rub 

 in for a considerable time every day, during a fortnight or so, 

 the following liniment : — 



Soap liniment ... ... ... ... ^ pint. 



Strong liquid ammonia ... ... ^ drachm. 



The pressure caused by the rubbing and the stimulating effect of 

 the liniment will generally make the tumour disappear. If the 

 enlargement does not yield to these simple means, we may pass a 

 seton through its centre in a vertical direction. We may with ad- 

 vantage adopt the advice of Schrader (MoUer's " Veterinary Sur- 

 gery "), who directs that a rubber tube, about the thickness of a 

 quill, should, without cutting the skin, be passed round the base 

 of the tumour, drawn tightly and the ends tied together with string. 

 If the base of the tumour be not well defined, we may use a pre- 

 liminary ligature of thin whip cord until the tumour in front of 

 it has swollen sufficiently for the rubber tube to retain its hold; 

 or we may transfix the tumour with a suitable skewer. The liga- 

 ture should be tightened from time to time as may be necessary. 

 The circle of constriction should be kept free from infection by the 

 use of a suitable antiseptic (p. 67). The tumour will fall off in 

 about a week. Its removal, owing to the presence in it of large 

 blood-vessels, should not be hastened by the knife ; although gentle 

 torsion may be employed. The subsequent wound may be treated 

 by, for instance, the plentiful use of iodoform or tannoform, or 

 by a solution of chloride of zinc, 20 grains to the ounce of 

 water. If the tumour is already hard and fibrous, we can safely 

 remove it with the knife, or ecraseur (Fig. 113, p. 289). To 

 do this, we should make a long vertical incision, preferably with 

 the hot iron, through the skin, and then carefully dissect the 

 tumour out with the knife, or pass the chain of the ecraseur over 

 it, and screw up the instrument until the base of the tumour 

 is cut through. It is advisable to apply a strong caustic 

 (such as 40 grains of chloride of zinc to the ounce of water) or a 

 red-hot firing iron to the wounded surface left by removal of the 

 tumour, so that the serous membrane may not continue to secrete 

 serous fluid and thus leave a running sore. Afterwards, tanno- 

 form, iodoform, or a saturated solution of iodoform in turpentine 

 or in eucalyptus oil may be freely applied to the part. 



