XII, B, 3 Abriol: Amoebic Abscess of the Liver 129 



Table III. — Quarterly distribution of liver abscess among Filipinos. 



Quarter of year. 



First ... 

 Second. 

 Third .. 

 Fourth 



On ad- 

 mission. 



At time of 

 onset of 

 abscess. 



9 



7 

 15 



Personal factors. — Liver abscess may occur at any age. Our 

 youngest case was 9 years old and the other extreme was 69 

 years. It is commonest between the ages of 21 and 40. Among 

 our 38 cases, 22 occurred between these ages. The average age 

 was 36 years and 9 months. Rogers, (22) in a review of 300 cases 

 of liver abscess among Indians and 92 among Europeans, comes 

 to the conclusion that the age incidence among Indians and 

 Europeans is similar. The majority of his cases both in 

 Europeans and Indians was between the ages of 21 and 40. 

 Reports on cases in old age are scanty. Oilman, in 1914 at the 

 December meeting of the Manila Medical Society, reported a 

 case of liver abscess in an Englishman who was 83 years old. 

 Amberg(i7) reports 5 cases in children, and RolIeston(i3) col- 

 lected 16 similar cases. 



In all endemic regions there is a predominance of cases in men 

 over women. Davidson (4) estimates the proportion of cases in 

 men to women as 30 to 1. The Indian statistics (4) for 1901-3 

 give the ratio of 7 to 1. Futcher(6) had a ratio of 8 to 1 in his 

 Johns Hopkins series. Many observers claim that women are 

 relatively immune to the disease, because they are less addicted 

 to alcohol and less exposed to other exciting causes of the disease. 

 "Van der Burg (13) ascribes it to menstruation, and this may 

 have a certain influence in diminishing liability to hepatic condi- 

 tions and indirectly to abscess." If the first argument be 

 tenable, and considering that the Filipino woman of the lower 

 class is as much subject to intemperance and as exposed to other 

 exciting causes of the disease as the man, we may with justice 

 ascribe to this the relative frequency of amoebic liver abscess 

 among Filipino women. In our series, seven occurred in women. 

 This gives us 22.8 per cent of all the cases, and the ratio of the 

 female cases to males is 7 :31 or 1 :4.43 -|-. 



In the opinion of most observers alcohol, particularly in excess, 

 plays an important role in the causation of the abscess, and here 

 we may say that the relative frequency of the disease in 

 Europeans and Americans is ascribed to the fact that they are 



