TUMOURS. 



6i 



o.- internally, and they may be malignant or benign, single or 

 multiple. 



In the case of malignant growths the benefit accorded by 

 operative measures can only be temporary; whatever the 

 variety the principles of removal by surgical methods are the 



Fig. 30. 

 Ecraseur (Cliassaignac's) with cliain. 



same. In those which have a distinct pedicle a ligature of 

 silk, catgut, horsehair, or some such material may be tied 

 firmly around this part and the tumour removed at once with 

 a sharp knife, or the ligature may be allowed to remain on for 

 two or three days before removal. In some cases resort is 

 made to the actual cautery and clam, or the ecraseur may be 



Fig. 37. 

 Tumour liuoks of iliffereiit patterns. 



used. When the latter instrument is employed the skin should 

 first be cut through, as, if left, the traction on this caused by 

 the chain or wire gives excessive pain unless an anjesthetic 

 is used, and in addition damages the edges somewhat severel)'. 

 In removing large tumours the hair over the line of incision 

 is removed by shaving, the parts being thoroughly cleansed 



