SURGICAL TREATMENT OF HYDATID TUMOURS. 179 



the method of treatment ; in another the unsuc- 

 cessful termination of the case arose from insufficient 

 attention to the dressing of the wound subsequently 

 to the evacuation of the cyst ; and in two more the 

 cysts existed in such numbers that every other mode 

 of treatment would have most likely been attended 

 with a similar result. 



The chief objections which have been urged 

 against the plan of treatment by caustic are : — 

 1. That it acts slowly ; 2. That its effects are occa- 

 sionally difficult to control ; 3. That it may cause 

 peritonitis ; and 4. That it does not always produce 

 adhesion. 



The first objection, which would have some weight 

 when a simple abscess is concerned, is not of any 

 value as regards hydatid tiunoiu-s ; besides which, 

 the opening of the tumoiu' may be accelerated by the 

 more frequent application of the caustic. In one 

 case, quoted by Davaine, the cyst was opened after 

 four applications of the caustic, extending over a 

 space of only seven days ; and in another instance 

 the cyst was opened on the seventh day, after the 

 application of the caustic at short intervals ; in this 

 second case more than six pints of purulent matter 

 and of hydatids were discharged upon the removal of 

 the eschar, and a marked improvement soon took 

 place in the health of the patient, who ultimately 

 recovered. 



The second objection does not hold good as regards 

 the Vienna paste, which is now generally used instead 

 of caustic potash. With respect to the risk of 

 causing peritonitis, no facts have been brought for- 

 ward in support of this statement. 



N 2 



