124 MALIGNANT TUMOUES. 



When employing it, carefully note the position of the many newly- 

 formed veins, which manifest themselves by their blue colour, and 

 ligature them before cutting through on the tumour side of the 

 ligature. The tying of one of these veins may be performed 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 exposed surface by pressing on it for a 

 m_oment 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 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. 



Fig. 44. — Torsion forceps. 



When 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) suoh as on© of carbolic acid or 

 creolin in water (1 to 20). Subsequent treatment will be similar 

 to that after castration. 



Great success has followed 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 ^ oz. 

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

 entire success in the treatment of scirrho'us cord. Some authorities 

 recommend that instead of iodide of potassium, biniodide of mer- 

 cury (p. 128) should be employed. This treatment, in the event of 

 removal by surgical means not being adopted, may be supple- 

 mented by injecting liniment of iodine, a couple of times a day, 

 into the sinus or sinuses with a syringe, or into the substance of 

 the tumour by means of a hypodermic syringe. 



