SURGICAL TREATMENT OF HYDATID TUMOURS. 1 83 



persons, — will assist the practitioner in judging 

 whether the hydatid cyst has undergone modifica- 

 tions of structure, and whether its contents have 

 become atheromatous ; in doubtful cases, an explo- 

 ratory puncture will render the diagnosis more 

 satisfactory. 



The hydatid cysts of the face, of the neck, and of 

 superficial parts of the body should be opened by 

 incision. 



It is important to open promptly the cysts which 

 are situated in the anterior part of the neck, in con- 

 sequence of their tendency to perforate the trachea 

 or other important passages, or to form a connection 

 with the thyroid gland. 



Incision is also indicated when a hydatid tumour, 

 which was primarily developed in an internal organ, 

 extends to the surface of the body, especially if its 

 projection, and a digital examination, together with 

 the redness of the surrounding integuments, further 

 lead to the opinion that the cyst has contracted 

 adhesions with the walls of the large cavity within 

 which it is contained. 



Operations upon hydatid cysts situated within 

 the chest have been too few in number to enable us 

 to decide what would be the best method of treat- 

 ment. Those cases which have been recorded tend 

 to show that the pleural layers are usually united by 

 adhesions, so that effusion of the cystic contents into 

 the serous cavity need seldom be feared. Dr. Davaine 

 gives the details of five cases of intra-thoracic hy- 

 datid cysts ; two of these were opened by the 

 bistoury, two by puncture, and one was treated by 

 puncture with the subsequent injection of a solution 



