178 ENTOZOA FOUND IN MAN. 



sions of the peritoneal surfaces are supposed to be 

 fully established, a second is made, extending into 

 the hydatid tumour, and the cyst is emptied. 



The method of opening hydatid tumours by the 

 apphcation of caustic has been known for a long 

 time, but it was only resorted to for the purpose of 

 evacuating the hydatid contents. Another more 

 important object may, however, be attained, namely, 

 the opening of a cyst situated in an internal organ 

 without the risk of effusion into the neighbouring 

 serous cavity. This operation is especially suitable 

 for the treatment of hydatids in the liver. 



The caustic is applied repeatedly at intervals of 

 a few days, in order that the adhesions produced by 

 the mflammatory action which is set up may effec- 

 tually prevent the escape of the cystic contents into 

 the peritoneum ; if the eschars, upon their removal, 

 do not lay open the cavity of the cyst, the aperture 

 may be completed by means of incision or puncture. 



The agents employed in this operation are caustic 

 potash, or the Vienna paste, which is a compound of 

 caustic potash with quicklime. 



Dr. Davaine gives the details of twelve cases, in 

 which this plan was the only one adopted ; in six of 

 these a cure was effected ; in one the termination of 

 the case was not learnt, but as the tumour rapidly 

 diminished in size, and as no immediate bad results 

 followed, the patient most probably recovered ; in the 

 other five cases death occurred at a variable period, 

 ranging from a few weeks to a few months after the 

 performance of the operation. An examination into 

 these five cases of failure shows that in one there 

 were nervous compHcations altogether independent of 



