162 HYDATIDS. 



right as well as in the left lobe, on its upper as well as 

 on its lower surfaces, down deep in the substance of the 

 gland, and cropping out from its surface or margins. 

 In the majority of cases there is but one cyst, but not 

 unfrequently there may be two or three, and in excep- 

 tional cases five or six may exist in the same organ. 

 Not unfrequently they occur in several organs simul- 

 taneously. Thus they will infest in vast numbers both 

 the peritoneum and the abdominal viscera, and some- 

 times the thoracic organs. 



Hydatids vary much in size and the direction they 

 take ; in magnitude the sacs may attain or even exceed 

 the diameter of a foot or more; they have been known 

 to fill the greater part of the abdominal cavity and the 

 right side of the chest. The more the cysts grow the 

 more is the glandular tissue compressed and mhnvii in 

 size. In the early stage the cysts may form a circum- 

 scribed tumour at one part of the liver, not lar-cr than 

 a Seville orange or Spanish onion; the alterations in 

 the form of the liver are as various as the dim -t ions in 

 which the cysts develop themselves ; the tumour is 

 neither dense nor doughy, but is as a rule elastic, and 

 sometimes fluctuating (the hydatid tivmulousness of 

 Rokitanski), particularly if the cyst be near tin- surface. 

 The echinococcus cysts (if not checked by proper treat- 

 ment) may become perilous through their great volume, 

 and when present in great numbers generally prove 

 fatal through exhaustion and great wasting and in- 

 dependently of their injurious effects upon the glandular 

 tissue, interfere with the functions of the adjoining 

 organs, and ultimately burst and empty themselves 

 through various channels. 



