Neoplasms 391 



est of surgery, illustrative of which I need only mention the follow- 

 ing incident related to me by a practitioner. A silk ligature was ap- 

 plied late one night to a wart growing at the edge of the eye-lid. In 

 the morning the corresponding eye was found to be damaged to such 

 extent that the sight was destroyed. The animal had practically 

 scratched its eye out during the night in its frantic efforts to rid 

 itself of the pain-giving ligature. 



The cleanest and best surgery calls for excision with the knife 

 and ligation of all severed bloodvessels. Where the main nutrient 

 vessels of a growth are not of large caliber and are comprised in a 

 distinct pedicle, the last step in the removal including hemostasis 

 may be effected by means of a good emasculator instead of ligatures, 

 but the operator must be sure of the adequacy of his instrument for 

 fear of secondary hemorrhage. Anesthesia, either local or general, 

 should always be instituted. Growths which can be ablated without 

 much cutting can be removed painlessly by narcotizing the subject 

 with morphine hypodermically administered some thirty to sixty 

 minutes previous to operation and then employing hypodermic in- 

 jections of cocaine locally, but those involving extensive cutting re- 

 quire a general anesthetic. It is always best to securely hopple the 

 animal. Instruments must be sterilized and the parts thoroughly 

 cleansed and freed of hair. When tumor and skin have coalesced, 

 an incision is carried through the latter on either side well into the 

 healthy texture. The subcutaneous tissue is divided all around the 

 diseased area by blunt, or if necessary, sharp dissection until one or 

 more pedicles supporting the nutrient vessels are exposed. The lat- 

 ter should then be ligated with silk and severed on the occluded side 

 with scissors, or they may be divided at their origin with an emas- 

 culator, which, however, should be allowed to remain clamped for 

 some little time to guard against subsequent hemorrhage. Every 

 trace of diseased neighboring lymphatics must also be freely re- 

 moved by dissection. All bleeding points should then be seized with 

 hemostatic forceps and either twisted or ligated. The wound being 

 cleaned, preferably with a stream of sterilized water, the divided 

 skin is reunited with the subcuticular suture, redundant portions 

 being removed with scissors. A drainage tube or strand of sterile 

 gauze should be inserted and stitched in place in extensive wounds, 

 particularly where the formation of pockets in the subcutis cannot 

 be prevented, and where drainage is not employed the parts must be 

 daily inspected for accumulation of pus to which free exit must be 



