TUMORS, 221 
with separated sutures, and the whole covered with a coat of collodion or 
with a dressing. . 
In every case, if possible, and even if the solution of continuity has to 
be large, complete extirpation should be made at one sitting. There are 
cases when successive interferences are necessary to remove a neoplasm in 
its entirety, and then there remains, in some parts of the large wound, 
small spots of repullulation which demand another surgical operation 
with the bistoury or the actual cautery. Quite often in sluts, notwith- 
standing the total removal of mammary tumors, another interference is 
necessary after a variable length of time; and even then the patient cannot 
be saved. 
Although we possess a certain number of observations on radical cures 
of neoplasms which histology had declared incurable, it is, nevertheless, 
true that the recidivity of malignant tumors is the general rule. 
Let us now consider the special methods of treatment of the various 
kinds of tumors. 
Fibromas, which are to be placed among the most benign growths, re- 
cidivate but very rarely after removal, and when they do they affect the 
structure of sarcomas. Some retrogressions are also explained by errors 
of diagnosis: carcinomas or sarcomas which had undergone fibrous trans- 
formation or growth were mistaken for simple fibromas. The ablation 
of fibromas is ordinarily done with the bistoury: if the wound remaining 
is small, first-intention cicatrization is possible. When the tumor is 
pedunculated, the ecraseur or elastic ligature can be used. The slow 
action of this latter, the putrefaction which takes place in the tumor 
before its complete section, and the fetid odor coming from it are objec- 
tionable ; for these reasons it is advantageous to combine ligature with 
excision ; twenty-four or thirty-six hours after the application of the ligature 
the tumor is cut off close to the ligature and the stump left to its 
spontaneous slough. Sometimes the actual or the thermo cautery are used 
also. Some sessile diffused fibromas may also be destroyed by actual or 
potential cauterization. 
Circumscribed myxomas are treated by total removal with the bistoury 
or ecraseur; sometimes they are torn off with the fingers. Diffused 
myxomas demand a careful dissection of the roots which extend into 
muscular spaces. The former rarely recidivate, the latter more com- 
_ monly. When they do, the new growth ordinarily offers the structure of 
asarcoma. For small animals, if a myxoma of a leg returns, amputation 
.is better than a second removal. 
When Zfomas are large and troublesome they are removed with the 
bistoury, The operation is very simple for circumscribed, but rather 
