128 STATISTICS OF CAUSES OF TROPICAL ABSCESS. 



Dr. Abercrombie, maintain that the frequent occurrence 

 of the two maladies is merely the result of accident. The 

 doctrine, which is most generally accepted at the present 

 day is that propounded some twenty years ago by Dr. 

 George Budd, of London thathepaticinflammation isthe 

 result of purulent absorption from the ulcerated colon 

 the result of dysentery ; in fact, the pathology of tropical 

 abscess appeared to him to be identical with the pysemic 

 abscesses so common in this country. Morehead, how- 

 ever, maintains with whom Frerichs, of Berlin, agrees 

 that the general cachexia induced by a long residence 

 in the tropics is the chief cause of hepatic disease, and 

 attributes the immediate exciting cause to a " chill." 

 This view, says Frerichs, is more in harmony with the 

 facts in the case of those abscesses of the liver which 

 accompany tropical dysentery. 



The following statistics, however, go far to prove that 

 dysenteryhas much to do with the tropical hepatic abscess. 



Of 29 cases collected by Annesley in India, 21 had 

 dysenteric ulceration of the lai-i* intestine. 



Of 25 cases collected by Haspel in Algeria, 13 were 

 similarly affected. 



Of 17 cases collected by Budd, chiefly anxm^ sailors 

 on board the old Dreadnought Hospital, in the Thames, 

 10 had ulceration of the large intestine. To counter- 

 balance these statistics as regards the frequency of 

 dysentery in connection with tropical abscess, we iind 

 that out of 300 cases collected by Waring in India, 

 dysentery preceded hepatitis in only 82 cases, or \ 

 per cent. The most conclusive cases, however, are 

 those in which the patients have died of hepatic abscess 

 and no sign of dysenteric ulceration found after death. 



