160 PARASITIC AMCEB^E OF MAN. 



to the liver abscesses occurring in these cases. While 

 liver abscesses occur without the presence of amoebae, 

 and even in cases of dysentery which are not due to 

 amoebae, this is no argument against the etiologic im- 

 portance of the parasite. In my studies of the form 

 of dysentery which is due to infection with the Shiga 

 bacillus, or bacilli belonging to that group, I have 

 observed abscess of the liver, but the abscesses were 

 so different, both in macroscopic and microscopic 

 pathology, from those due to amoebae that no mistake 

 could be made in distinguishing them. 



The question has been raised as to whether an 

 amoebic abscess of the liver ever occurs primarily, 

 no other symptom of amoebic infection having been 

 noticed, and there can be no doubt that a few 

 authentic instances have been reported, such as the 

 case recorded by Buxton in the person of a woman 

 who died at the Philadelphia Hospital. The autopsy 

 showed four large abscesses in the right lobe and one 

 in the left lobe of the liver the pus of each containing 

 amoebae, but the most careful examination of the 

 intestine showed no evidence whatever of dysenteric 

 infection. Such a case as this, recorded by a com- 

 petent observer, is conclusive evidence that amoebic 

 abscess of the liver may occur without a pre-existing 

 dysentery. In the vast majority of cases, however, 

 there is a history of dysentery and the abscess occurs 



