AUSTRAL] \. 147 



the eighth costal cartilage downward. On cutting 

 through the abdominal wall (he retroperitoneal location 

 of what now could be recognized as a cyst was ascer- 

 tained without any difficulty, the ascending colon being 

 displaced inward. Marsupialization was resorted to. 

 This term is often employed by Australian surgeons 

 to indicate the radical operation for echinococcus cysts 

 and the treatment of other cysts by incision and drain- 

 age. This word was coined here and owes its origin 

 to the many species of marsupial animals which in- 

 habit Australia, animals which give birth to their off- 

 spring in the embryonic state and mature them in a 

 pouch on the ventral side of the body, where the young 

 have easy- access to the milk-supplying breasts. After 

 opening and stitching the sac to the abdomnial incision, 

 the dermoid character of the cyst was demonstrated by 

 the escape of a large quantity of hair and sebaceous ma- 

 terial. The patient was doing well, relieved of all sub- 

 jective symptoms, and only a small quantity of a mu- 

 coid fluid was discharged daily through the drain 

 which remained in the c}-st. Such cases in this particu- 

 lar location are extremely rare, and it is to be hoped 

 that a full report of the case will soon find its way 

 into the current medical literature. The safety of the 

 operation was enhanced in this case by previous firm 

 adhesions between the two layers of the peritoneum, so 

 that the marsupialization was practically extraperito- 

 neal. It has been observed in this, as well as in other 

 hospitals of Australia, that the aborigines are more 

 frequently afflicted with hydatids than the whites, as 

 they are more exposed to infection, living with numer- 

 ous dogs, and often obtaining their water supply from 

 stagnant pools. Dr. Altman, of Bright, has operated 

 on many natives afflicted with this disease. All sur- 

 geons consider the natives good subjects for narcosis 

 and capital operations. They are. however, very prone 

 to homesickness and shorten their stav even in the best 



