222 VETERINARY SURGICAL THERAPEUTICS. 
difficult for diffused, lipomas. If the tumor is voluminous, an elliptical 
cutaneous flap is removed with it. Union by first intention or sutures 
with drainage, according to the extent of the wound, complete the removal. 
Papillomas are generally not serious. They are destroyed with the 
bistoury or the ecraseur (ligature with silk threads) when well peduncu- 
lated, or repeated cauterization of nitric acid. Radical recovery of 
warts and cutaneous growths require ordinarily the removal of a portion 
of the skin where they are implanted. Papillomas of the mucous mem- 
branes (vulva, vagina, uterine neck) are treated with excision; some- 
times they return and require being operated upon again after a variable 
length of time (weeks or months) ; but even in these cases radical recovery 
is not rare. 
For cysts two methods can be employed: (1) Extirpation of the growth ; 
(2) evacuation of its contents, and local application of agents to promote 
the granulating inflammation of the walls of the cyst, the obliteration of 
its cavity, and the shrinking of the walls of the sac. 
Extirpation with the bistoury is the surest and quickest way, and ought 
to be used whenever the operation can be performed easily and without 
danger. Elastic ligature is advantageous for some pedunculated cysts. . 
The other mode of interference includes several ways. For serous and 
most mucous cysts, the evacuation of the contents by a capillary puncture 
and the injection into the cavity of an irritating fluid (pure or diluted 
tincture of iodine, a strong carbolic solution) are at times sufficient; 
after the injection, especially if before the removal of the injected fluid 
the tumor has been kneaded by the surgeon, the wall of the sac has be- 
come inflamed and vascular, a sero-fibrinous exudation takes place; 
then gradually this serosity is absorbed, the walls of the sac retreat and 
the cavity disappears. The free incision of the wall of the cyst is another 
process which brings on recovery in a different manner: the cystic mem- 
brane, then exposed, loses its epithelium, suppurates, is covered with 
granulations which fill the cavity, thus constituting a more or less volumin- 
ous mass of embryonic tissue which afterwards becomes organized and 
contracts. Multiple punctures and capillary or tubular drainage bring on 
the same result; sometimes recovery is slow, but it can be stimulated 
with irritating injections into the cavity. Deep cauterization, which also 
gives good results, is especially advised when the walls of the cyst are 
thickened by previous unsuccessful treatments. 
Sarcomas require early, entire removal, which even does not insure 
against their return. Still, recovery in numerous cases follows a single 
well-performed operation. When this is performed for sarcoma of soft 
parts, one must bear in mind that the fibrous capsular sheet, which ordi- 
narily isolates the morbid tissue, is part of the neoplasm and envelops it 
