HEPATIC ABSCESS. 129 



Morehead records 17 cases of abscess without a single 

 sign of intestinal tilceration ; and out of 204 cases of 

 hepatic abscess collected by Waring, not a sign of 

 ulceration, cicatrices, or abrasions was found in the 

 intestines of 51 cases being exactly one-fourth. It is, 

 therefore, clear from those statistics that we must look 

 for other causes than dysentery as productive of 

 tropical abscess. 



SYMPTOMATOLOGY. It would be extremely difficult, 

 if not impossible, to lay down a clinical history of 

 hepatic abscess, which would act as an undeviating 

 guide in the diagnosis of all cases ; inasmuch as the 

 complex and ever- varying train of symptoms presents 

 so many changes, depending on the topographical area 

 of the inflammatory deposit and its concomitant morbid 

 processes. It. is also worthy of note that medical 

 history records many cases of suppurative inflammation 

 in the liver, the existence of which was not known or 

 even suspected during life ; and yet post-mortems have 

 brought to light abscesses of a prodigious size. Budd 

 records the case of a Lascar, age 62, admitted into the 

 Dreadnought, October 2, 1839, seemingly only suffer- 

 ing from catarrh and general emphysema, and only 

 complained of general weakness, night sweats, and hectic 

 fever : he died on the 12th November following. A post- 

 mortem brought to light an abscess which contained over 

 a pint of pus, with traces of dysenteric ulcers in the 

 intestines. Andral gives the history of a young man, 

 who, after a long ride on horseback, fell ill with feverish 

 symptoms ; on the fourth day he had rigors, headache, 

 a white tongue, loss of appetite, and obstinate consti- 

 pation ; on the twelfth day he became delirious, and on 



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