TREATMENT SURGICAL. 173 



cardium ; and Arsenicum has in my hands cured two 

 cases of the " Ascites saccatus," or sacculated dropsy, in 

 other words, " hydatids," with the help of the salt water 

 compress. 



SURGICALLY. We now come to the most important 

 section of the treatment of hydatids the use of the knife, 

 with other surgical appliances, and electricity. Several 

 modes of operating have from time to time been adopted 

 with varying results, to these I shall now briefly refer. 



1. The Simple Puncture,. This mode has been adopted 

 with both large, medium, and small-sized trocars. This 

 plan has generally been found free from danger, provided 

 the adhesions are sufficiently complete to prevent any 

 of the fluid from escaping into the cavity of the chest, 

 or the peritoneum. It may be that one puncture may 

 suffice to effect a cure; but in other cases several 

 operations of a like kind may be required before the 

 " cyst," is completely destroyed. 



2. The puncture of the hydatid, with subsequent 

 injection of water, a solution of iodine, port wine, or 



bile. 



ving first plunged the trocar into the cyst, the 

 trocar is withdrawn, and the canula is allowed to 

 lin in the cyst, through which pure water is first 

 injected to wash out the pus, and shreds of the hydatid 

 membrane, then diluted alcohol, a solution of iodine, or 

 even bile is injected into the cyst. Favourable results 

 generally follow either of these solutions. 



lUle has been selected from the fact, that it kills the 

 echinococci ; moreover it acts as an antiseptic, and so 

 iodine. 



3. The opening of tlie hydatid, by means of caustic, 



