124 The Philippine Journal of Science 1917 



out of 95 cases ; in Craig's (18) series of 78 fatal cases 33 per cent 

 showed liver abscess, and in his 745 collected cases of amoebic 

 dysentery in which amoebae were found in faeces 5 per cent showed 

 abscess of the liver. Kartulis,(i9) in 500 autopsies, showed 55 

 per cent- amoebic abscess of the liver. Councilman and 

 Lafleur,(i9) in their autopsies, numbering 1,429, report 21 per 

 cent with abscess of the liver. Zancarol diagnosed it in 59 per 

 cent of 444 autopsies, Edwards and Waterman (19) in 72.1 per 

 cent out of 699 cases, and Coffin (17) in 34 of 859 cases among 

 American soldiers. Musgrave reports 12 cases out of 100 cases 

 of amoebiasis in St. Paul's Hospital, Manila. McLeod,(20) in 40 

 cases of amoebic abscess of the liver in Shanghai, had positive 

 evidence of dysentery in all except one, and in this there was 

 no certainty that dysenteric lesions did not exist. 



There are latent and marked infections of intestinal amoebia- 

 sis (21) which are often overlooked, the patients denying a 

 history of dysentery and presenting no symptoms referable to 

 amoebiasis. Some of these cases go on to recovery or death 

 without ever showing active diarrhoea. Therefore we may have 

 patients who have had no history of dysentery and at the same 

 time have active amoebic lesions in the bowels. Amoebic liver 

 abscess in such subjects gives an impression of having no rela- 

 tion to intestinal amoebiasis. But we must also bear in mind 

 that there may be "individuals who had previously suffered from 

 amoebic colitis, which had finally healed and in which the amoebae 

 reached the liver during the period of active ulceration of the 

 colon." (9) This might have been a latent form of which the 

 patient knew nothing, and autopsy in fatal cases may show only 

 traces of previous amoebic ulcerations. Rogers (22) calls atten- 

 tion to the fact that amoebic lesions in the bowels may be 

 frequently found post mortem in cases in which there were no 

 symptoms nor history of dysentery during the treatment of the 

 patient for liver abscess. He (22) reports 63 cases of liver 

 abscess of which 35, or 55.5 per cent, had clinical and post- 

 mortem evidence of dysentery; 13, or 20.6 per cent, no history, 

 but with post-mortem evidence of dysentery ; 9, or 14.3 per cent, 

 with history, but no post-mortem evidence of dysentery; and 6, 

 or 9.5 per cent, without a history or post-mortem evidence of 

 dysentery. This datum gives us definite evidence of dysentery in 

 90.5 per cent. In another series of Rogers's (22) of 45 cases 97.8 

 per cent showed either the presence of active lesions or scars 

 of former dysentery. In a third series, this time clinical cases, 

 Rogers (22) elicited a history of symptoms of dysentery in 72 per 

 cent. Other cases of liver abscess, showing their relation to 



