208 



OPERATIONS ON THE SKIN AND CELLULAR TISSUE. 



Fig. 289— The Liga- 

 tures Secured. 



Fig. 238.— The Tumor dlTided 

 In Four. 



Fourth Method, Subcutaneous Ligature.— This method is sel- 

 dom practiced, as there are always objections to leaviag under 

 the sMn the mortified structures divided by the constriction of the 

 cord. But as there may be circumstances imder which the growth 

 cannot be immediately uncovered, its application becomes a ques- 

 tion of necessity. 



Three needles are required: one. A, straight and sharp; the 

 second, B, straight and pointed; the third, C, curved and also 

 poiuted. These are placed upon a single long thread. 



Fig. 240.— Thread and Needles lor Subcutaneous Ligatures. 



Fig. 241.— 1st Step. 



The growth A beiag subcutaneous, and spherical in shape, a 

 vertical cutaneous fold is raised above its superior third, through 

 the base of which the needle A is introduced. Leaviag the fold 

 loose, and the skin resumiag its position, a first portion of Uga- 

 ture is found in place, under the teguments, surrounding one- 

 third of the circumference at C (Fig. 241). The curved needle, C, 

 is then passed through the tumor, entering at C, and coming out 

 at B, vsith the loop D, and at B the needle is removed (Fig. 242). 



By these first steps of the operation, the superior third of the 

 growth is surrounded by the loop of thread B,C,D,both of whose 



