Lectures on the operations of surgery : and on diseases and accidents requiring operations . rmity. You can, with great propriety and safety,cut through the sound integument, and make your incision in sucha direction as to cause as little deformity as possible. Perhaps aportion of the skin is affected, yet the tumour is very extensive in TUMOURS OF THE FACE. 223 the subcutaneous tissue, and then you may cut round the discolouredparts of the surface in the sound skin, make an incision throughthe skin at the corners, and dissect back the flaps so as to uncoverthe tumour completely. Sometimes the
Lectures on the operations of surgery : and on diseases and accidents requiring operations . rmity. You can, with great propriety and safety,cut through the sound integument, and make your incision in sucha direction as to cause as little deformity as possible. Perhaps aportion of the skin is affected, yet the tumour is very extensive in TUMOURS OF THE FACE. 223 the subcutaneous tissue, and then you may cut round the discolouredparts of the surface in the sound skin, make an incision throughthe skin at the corners, and dissect back the flaps so as to uncoverthe tumour completely. Sometimes the coverings of the diseasedpart are quite sound, and of their natural colour; you may thensave all the integument, and if you can, so much the better. Inuncovering an erectile tumour you may do it without risk of hemor-rhage, but if you cut the deeper parts the probability is that youwill have great difficulty in arresting the hemorrhage. You proceedto detach the tumour in this way. Your first business is to pass aneedle under the tumour completely, and without any ligature in it Fig. at all. You then carry another needle, with a ligature you intendto use, across under the other needle, raising the tumour towardsthe surface by the one first introduced. The object in not passing aligature in the first instance is that you may not entangle the liga-tures. You then thread the first needle with a small thread attachedto a strong ligature, and draw that through. You then detach thisthread, and you have two double ligatures underneath the separate the ligatures, and then you take two of them, it is in-different which, and an assistant holds the others all very tie these so that you will have three knots, and a reef-knotover all, to prevent them slipping. You then take up two of theother ligatures, and tie these also in the same fashion. You takethe third pair, and while the assistant holds the remaining two, 224 TUMOURS OF THE FACE. very firmly draw these
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