618 
TAIT BUTLER. 
On approaching- the animal for the operation, the surgeon 
should place his left shoulder against the left side of his 
patient, and with his left hand grasp the testicle which is 
drawn the closer to the body, when with a scalpel, held in the 
right hand, he may expose it by cutting through the envelop¬ 
ing membranes with one firm, quick, and free movement from 
before backwards. The testicle having been exposed, the 
next step is its removal. This may be, and in fact is, done in 
many ways, but to my mind only two are worthy of approval. 
One is to remove it with an ecraseur and the other to ligate 
the cord and remove it with a knife. I prefer the former 
method because, all things considered, it is of greater practical 
utility. That is, if the more surgical method of ligating the 
cord has the advantage from a scientific standpoint, that is 
more than counterbalanced by the greater convenience of the 
ecraseur. The question is, does the advantage, if any, pos¬ 
sessed by the ligature, justify the extra amount of work re¬ 
quired ? In my opinion it does not, but we shall nevertheless 
briefly consider the modus operandi of both methods. 
To remove the testicle with the ecraseur, pass the fingers of 
the left hand through the loop formed by the chain and grasp¬ 
ing the testicle draw it gently down and apply the chain suffi¬ 
ciently high on the cord to include in the part removed a small 
portion of the tunica vaginalis reflexa at the frenum. This is to 
remove the small pocket formed by the loose portion of this 
membrane retracting and slightly folding upon itself owing to 
the adhesions at the posterior part of the cord. The chain 
being properly adjusted, the testicle may be removed by slow 
interrupted turns of the ecraseur screw. The testicle having 
been removed I enlarge the incision in the scrotum, making it 
from three to five inches in length according to the size of the 
testicle removed. I then by means of an insufflator, thor¬ 
oughly'disinfect the cavity with the “ pulvis iodoformi dilu- 
tus ” of the National Formulary. This completes the operation 
and for after-treatment I recommend only good care and 
plenty of gentle exercise after the first twenty-four hours. 
Two methods of ligating the cord will be briefly described. 
One is adapted to the standing operation and has to a limited 
