12 



Since the foregoing observations were recorded to the Manila 

 Medical Society in 1902, F. Haasler,^ in the same year, in an 

 article treating of the complications of amoebic dysentery and re- 

 viewing 600 cases of the disease occurring in China, mentions three 

 of severe intestinal bleeding, in two of which the hemorrhage was 

 considered the cause of death. In one of the cases about 4 

 liters of blood was passed and the author was able to find at 

 necropsy a thrombosed vessel from which the bleeding occurred. 

 A most interesting fact in connection with these cases and one 

 emphasized by the author is that, in both of the fatal instances in 

 which death was due to the hemorrhage, liver abscess coexisted. 



Woodward- in 1879 also reported two cases of dysentery in 

 which profuse hemorrhage occurred and in which large liver 

 abcesses also existed. In the first instance death resulted immedi- 

 ately from the hemorrhage. Though the cases were not diagnosed 

 as those of amoebic d3^sentery, there can be little doubt from the 

 histories and autopsies that they were indeed instances of this 

 variety of the disease. 



During the past two years I have encountered two more fatal 

 cases of amoebic dysentery with severe multiple hemorrhage in 

 both of which large liver abscess was present. In the last one the 

 time of coagulation of the blood was not complete until nine 

 minutes. There Avas no marked jaundice present. These cases may 

 here be briefly recorded : 



Case Xo. 3. Chroxic Amcebic Dtsenteby; Multiple Liveb Abscess; 

 8E^'ERE Intestinal Hemorehages; Death; Autopsy. 



The patient, age 27 years, was first seen in October, 1903. At this time 

 his general phj'sical condition was fair, but he was already suffering with 

 a well-advanced case of amoebic dysentery of about two months' duration. 

 The stools were numerous and contained large amounts of blood-stained 

 mucus. He was placed upon local treatment of high quinine enemata and 

 pursued this treatment daily for nearly four months. During this time 

 his general condition gradually improved. On several occasions, for one 

 or two weeks at a time, the stools became fairly normal, one or two per 

 day, and contained no amoebae and no mucus or blood; but notwithstanding 

 the fact that the local treatment was continued, the disease always broke 

 out afresh and amoebse and mucus and blood reappeared in the stools. 



^Deutsche Medicin Wochenschr., 1902. 



''Medical and Surgical History of War of the Rehellion. II Med. Vol., 

 pp. 1C4 and 200. 



