ABLATION OF TUMORS. 205 



{d) With the Thermo- Cautery—The ablation of tumors can 

 also be performed with the flat platinum cautery of Paquelin, 

 well heated, by following the same rules as with the bistoury, 

 both when either the growths are small, or the incision of the skin 

 and dissections of the tumor have been previously performed. 

 The advantages gained by the use of the red-heated cautery in 

 controlling the hemorrhage whUe the incision goes on, is too ob- 

 vious and important to be ignored or depreciated. 



2d. LiGATUKE. 



The ligature operates on the tumor in its own peculiar and 

 effective way, by circumscribing the base and depriving it of its 

 nutriment by occluding the circulation and leaving it to undergo 

 the process of gangrenous dissolution and sloughing, with the ad 

 vantage of obviating any apprehended danger of subsequent hem- 

 orrhage. The kind of ligatures used for this purpose will vary 

 with the choice of the practitioner. In veterinary surgery, the 

 material is variously flax, hemp, silk, catgut, india rubber cords, or 

 metallic wire. Whipcord or fishing line is often used, when a 

 powerful constriction is to be applied, and theii- efficiency is in- 

 creased by being waxed or soaped. There are various ways of 

 applying a ligature, but they are all subject to the following rules: 

 the size of the ligature must be proportioned to that of the parts 

 to be Ugated, and to their resistance ; it ought to be applied only 

 upon a limited portion of the tissues, and the skin ought never to 

 be included, except when the peduncle is very narrow, or the skin 

 already ulcerated. 



First Method, Simple Ligature. — A cord or band is affixed 

 around the base of the tumor, and tightly tied by a single knot. 

 Sometimes the bleeding knot or double clove-hitch is preferred, 

 drawn tightly and secured by a simple knot. 



The mortification of the growth may be accelerated, if thought 

 proper, by covering the ligature with some caustic preparation, 

 such as an ointment of sulphide of arsenic, or also by adding to 

 the effect of the ligature that of the actual cautery. 



Second Method, Double Ligature. — This is 

 brought into requisition when the peduncle of the 

 tumor is too large to be easily embraced by a sin- 

 gle hgature. It is made by piercing the base of the j,jg 230.-TapeBtry 

 growth through the centre, by means of a straight Ligature. 



