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feet ceases. As regards the hard and firm tumours which
grow from the gums, and are not connected with diseased
teeth or fangs, they should be removed by the use of a liga-
ture drawn round their bases ; and if this is broad, a needle
may be passed through them, carrying two threads, and then
each thread may be brought around on each side and tied,
so as to firmly embrace the tumour, and it will soon slough
away.
Excision in these cases has been practised in some in-
stances, but the objection which has been raised to this, is
the profuse haemorrhage which occasionally follows, so as
even to require the actual cautery to arrest it. In other
cases, the haemorrhage is slight, but the fungus is apt to be
reproduced, so that probably the safest and most advanta-
geous mode of removing these tumours, is by the use of the
ligature.
I will introduce a case of this kind, remarking that in every
case of tumours from the gums, a critical examination of the
gums should be had, with a view of detecting any fangs of
teeth which may possibly remain in the jaw, and produce the
swelling.
Case XXV*—About the year 1815, a lady from the in-
terior of Pennsylvania applied to Dr. Physick respecting a
tumour of her gums over the left cuspidatus. It was of a
spongy nature, and about the size of a walnut, greatly dis-
figuring the face, and preventing the patient from shutting
her mouth.
The attending surgeon of the family had repeatedly ope-
rated upon it, and had removed the tumour twice with a
knife, and I believe, on the second occasion made use of the
actual cautery, but never to the effectual extirpation of the

Koecker, pages 264, 265.