EPITHELIAL TUMORS. 345 



possible -without surgical interference. The methods of radical 

 removal of tumor are as follows (these do not include torsion or 

 twisting) : 



Ligation. This method may be applied in all < ases where the 

 base of the tumor is not too broad, and if it has not penetrated 

 deeply into the tissues. It is useful in many forms of warts, 

 fibromas, and sarcomas; but, as a rule, it is objectionable because 

 it acts slowly, is extremely painful, produces great inflammation 

 with suppuration, and the tumor has a tendency to return. Ligate 

 the base of the tumor with a strong silk thread or a rubber band. 

 Another method which is more rapid is the use of the §craseur, 

 either by chain or wire. The chain of the 6craseur is put around 

 the base of the tumor, and greatly tightened by means of the 

 instrument, when the tissues are gradually crushed. The author 



Fig. 74. 



Wire 6craseur. 



has used the wire-loop, shown in its simplest form in Fig. 74, for 

 the removal of epulides. The bleeding, as a rule, is very slight 

 if the crusliing is done slowly, but there is always a danger of 

 recurrence of this condition. We must, therefore, touch the 

 open space left after the remos'al of the tumor with a thermo- 

 cautery. 



Cauterization. We may destroy tumors of the cutaneous or 

 mucous membrane, flat warts, etc., by means of Paquelin' s thermo- 

 cautery, or we may use some of the various cauterizing substances. 

 The best form of using this treatment is by the instrument illus- 

 trated in Fig. 75 (page 346). This instrument is based on the 

 fact that platinum, under certain conditions, very readily takes a 

 red-heat at a low temperature. The instrument is made in the 

 form of a pipe or cylinder, with different forms of platinum fitted 

 on the end. By means of an ordinary blowpipe or hand-bulb 

 a fine spray of benzine or rhigolene is thrown on the heated plati- 

 num end, causing constant combustion, and if the flame is kept 

 steady it reaches a white heat. This instrument has the advantage 

 of being kept at an even heat for a long time, and on account of 

 this steadiness is especially valuable in controlling hemorrhages. 



The caustic chemical substances, such a^^ burnt alum, caustic 



