APPENDIX 289 



to their growth is obtained. Here they penetrate and 

 undermine the mucous membrane, producing their effects 

 by liquefying the tissues, and thus causing ulceration and 

 necrosis. In the mucous membrane they are found chiefly 

 in the submucosa, in the lymph-spaces and blood-vessels, 

 and in the gelatinous contents of the ulcers. They may 

 penetrate to the liver either by the portal vessels or through 

 the peritoneum (sometimes causing peritonitis), and set up 

 abscesses, which in the former case may be multiple, in the 

 latter lie close to the surface of the right lobe, the com- 

 monest position. According to Councilman and Lafleur, 

 the liver shows no inflammatory reaction, and the abscess- 

 cavity is filled, not with pus, but with debris of liver tissue, 

 or sometimes a necrosed mass ; the contents may, however, 

 be old pus, the suppuration being due to the action of 

 micro-organisms conveyed by the amoebae (Kartulis). The 

 liver abscess may extend directly so as to involve the lung, 

 or the amoebae may traverse the diaphragm and set up 

 an abscess by liquefying the tissue ; but here the cavity is 

 surrounded by an area of interstitial inflammation. That 

 the micro-organisms do not travel by the lymphatics is 

 shown by their absence from the mesenteric glands ; and 

 they have no special preference for the lymphoid follicles. 



Antc-mortem they may be found in the stools, particu- 

 larly the gelatinous particles, in the pus from liver abscesses, 

 and in the sputum in cases of abscess of the lung, and may 

 be examined in the fresh state, best on the warm stage, or 

 in cover-glass preparations ; or sections may be cut from 

 portions of faeces hardened and imbedded in celloidine. 

 Councilman and Lafleur obtained the best results with 

 sections of tissue hardened in alcohol and stained in 

 Loffler's methyl blue, by which method the amoebae are 

 coloured dark blue, but unevenly. The nuclei are best 

 brought out by hardening in Flemming's solution (see 



