AUSTRALIA. 105 



the acute form of the disease antitetanic serum haa 

 been found absolutely worthless as a curative agent. 

 Hydatids are very common in the southern part of 

 Australia, Adelaide and Sydney furnishing the largest 

 percentage. The physicians attribute the disease to the 

 drinking water. It affects most frequently the liver 

 and lungs, but spares none of the internal organs. Op- 

 erations on the brain for hydatid cysts figure in almost 

 every hospital report. In all of the museums may be 

 seen beautiful specimens of hydatids of the bones ob- 

 tained by operation or postmortem specimens illustra- 

 tive of the extensive destruction of the entire shaft of 

 the large long bones. It is also frequently found in the 

 fascia and omentum. The disease is very rare in 

 Queensland, resembling the geographic distribution of 

 the disease in G-ermany, where it is very common in the 

 northern part and rare in the southern. It has been ob- 

 served in children from 3 to 4 years old. It pursues a 

 more rapid course in the young than in the aged. Its 

 course varies in different individuals. It may become 

 latent when the cysts shrink and the symptoms subside. 

 As the disease is often multiple, more especially in the 

 liver and omentum, a number of operations may be- 

 come necessary, as the surgeons have learned by expe- 

 rience that it is not wise to undertake too much at one 

 time. Dr. Bird operated on a patient suffering from 

 hydatids of the omentum nine times before he was able 

 to eliminate all the cysts. The axray never fails in 

 locating cysts affecting the upper surface of the liver ; 

 this diagnostic resource invariably yields a negative re- 

 sult when the under surface is affected. The methods 

 employed in operating for hydatid cysts of the liver 

 are not uniform. Dr. Bird cuts down on the cyst, 

 makes a free incision, inserts the index finder, brings- 

 up the margins of the cut and stitches them to the 

 external wound, extracts the lining membrane and 

 drains. In operating for a cyst on the upper surface 

 of the liver he resects a short piece of the eighth rib 



