182 ENTOZOA FOUND TN MAN. 



mation of an important organ, or of a large serous 

 cavity. 



The state of the tumour, its situation and its 

 relations, and the condition of the neighbouring parts, 

 will guide the operator in the choice of the most 

 appropriate method of operation. 



When the cyst contains a limpid fluid, and its 

 walls are thin and elastic, a simple puncture will 

 completely liberate the liquid if the hydatid be 

 single, and a cure may thus be obtained. Successive 

 punctures will be indicated when the tumour is of 

 very considerable size. If the hydatids be multiple, 

 a simple puncture will be insufficient ; and the injec- 

 tion of alcohol, or of tincture of iodine, will form an 

 useful addition to the treatment. 



It may be presumed that the hydatid is single, or 

 multiple, according to the relative quantity of fluid 

 which is withdrawn, as compared with the size of the 

 tumour previous to the operation. 



If the tumour contains thick atheromatous matter, 

 and the remains of a large number of hydatids, and 

 if the walls are hard, cartilaginous, or osseous, a 

 large aperture should be made for the escape of the 

 cystic contents ; under these circumstances, puncture 

 with a good -sized trocar, incision, or cauterization 

 with Vienna paste should be employed. Suction by 

 means of a syringe, or drainage tube, and the injec- 

 tion of a full stream of water, or of an iodised 

 solution, will constitute the treatment to be adopted 

 subsequently to the operation. 



The age of the tumour, and in some instances the 

 age of the patient, — the cretaceous deposition ap- 

 pearing to be more frequent in old than in young 



