SURGICAL TREATMENT OF HYDATID TUMOURS. 177 



adhesive inflammation of the serous membrane is 

 produced, and the effusion of the matter contained 

 within the cyst into the peritoneal cavity is pre- 

 vented. 



The method of treatment by repeated punctures, 

 which has been equally successful with the plan just 

 described, has for its object the gradual diminution 

 of the size of the tumour, so that the cyst may have 

 sufficient time to contract upon itself, and that the 

 neighbouring viscera may gradually resume their 

 normal position. 



Incision has been resorted to principally when 

 the hydatid tumour, forming a projection at the 

 surface of the body, has threatened to burst, or when, 

 in consequence of an error in diagnosis, the character 

 of the tumour has been mistaken. 



In a large proportion of the cases in which this 

 operation has been performed, the termination of the 

 affection has proved successful ; but it should be 

 observed that in the majority of these cases it was 

 not requisite for the incision to traverse any serous 

 cavity in order to reach the cyst, or else that the 

 adhesions established between the tumour and the 

 adjacent parts had formed a secure protection against 

 the escape of the contents of the cyst into the pleura 

 or the peritoneum. 



The operation of incision at two distinct periods 

 has only been practised upon a few occasions. Its 

 object is to prevent the contents of a cyst situated in 

 the liver from passing into the peritoneum ; the first 

 incision is made to extend as far as the peritoneum, 

 and the bottom of the wound is plugged with a piece 

 of lint ; after an interval of a few days, when adhe- 



N 



