166 SYMPTOMATOLOGY. 



" I have found," says Frerichs, " a ' hydatid ' in the liver 

 as large as a man's fist which had occasioned no remark- 

 able symptom, and whose presence had consequently not 

 been recognised during life." I have myself found an 

 ABSCESS in the liver sufficiently capacious "when 

 empty " to hold a quart-pot, which some of my 

 rti/i/reres failed to discover, but which was diagnosed by 

 myself, and confirmed by Dr. Vaughan Hughes. In 

 the majority of cases, however, local changes take 

 place which will indicate beyond doubt the presence 

 of a "hydatid," or some other abnormality 

 knowledge of which must be obtained by a thorough 

 investigation of the 1 f the case. In the gi 



rality of cases, however, particularly when the hy<i. 



;.iirly developed, local changes take place, which 

 indicate, and that without little doubt, the existence of 

 hydatids. The liver increases in size, and may be tr 

 projecting into the chest or the abdominal cavity, or at 

 other times in both directions ; by so doing it naturally 

 loses its normal form. It may xi-'iid upwards as hi. 

 the second rib ; it may extend down war-Is as low as the 

 pelvis ; and r rally either to the right or 



to the left; its boundaries in either case are to be d 

 mined by palpation and : -n, and in some C 



by the aid of the ear, and stethoscope. Hearing in mind 

 the normal position of the abdominal viscera, as laid bare 

 to us on the dissecting-room table, and taking into 

 consideration the history of the case in all its 1 

 inus, we shall have, in the majority of cases, but little 

 difficulty in arriving at a correct diagnosis. It is next 

 to an impossibility to describe all the various modifi- 

 cations of form which echiuococci of the liver may 



