SURGICAL TREATMENT OF HYDATID TTJMOUBS. 175 



its absorption. This plan is worthy of a trial in 

 those cases in which the application of the frigorific 

 mixture would not be attended with inconvenience 

 or with danger to the organs situated in the vicinity 

 of the cyst ; Dr. Arnott's mode of producing cold is 

 the best which could be adopted. 



The surgical operations which have been proposed, 

 and practised, in the treatment of hydatid tumours 

 may be arranged into three classes : — 



1. Those which procure the evacuation of the 

 contents of the cyst ; 



2. Those which procure the modification, or the 

 absorption of the matters contained within the 

 tumour ; 



3. Those which have for their object the extir- 

 pation of the cyst. 



The evacuation of the contents of the tumour is 

 accomphshed in various ways ; these are the single 

 puncture, repeated punctures, puncture with the 

 formation of a permanent opening, simple incision, 

 repeated incisions, and the application of some 

 caustic. 



Simple puncture has been performed with a view 

 either to enable the practitioner to ascertain the 

 nature of the tumour, or to bring about its cure. 

 The exploratory value of this method has been 

 already described, so that only its advantages and 

 its drawbacks need now be discussed. 



When the trocar does not have to pass through 

 any important organ, or any serous cavity, in order 

 to reach the cyst, the operation will be harmless ; 

 but when it must traverse a large serous cavity, a 

 puncture, even although made with a capillary 



