130 '^he Philippine Journal of Science i9it 



more addicted to liquors than the natives. Likewise European 

 women and children are less intemperate, and hence the in- 

 frequency of the disease in these individuals, Musgrave(9) 

 warns us of giving alcohol a too prominent place in the etiology 

 of liver abscess, basing his conclusions on his series in which 

 alcohol was not an etiological factor. In our series, four gave a 

 history of drinking "vino," ^ but as all of these except one had a 

 recent history of dysentery, we cannot conclude that alcohol was 

 an etiological factor in these instances. 



Excess of animal food and use of hot condiments such as 

 curries and probably pepper are said to contribute, along with 

 other causes, in the formation of liver abscess. Davidson (4) 

 states that the influence of excesses of this kind is overestimated, 

 and cites the infrequency of liver abscess among the better class 

 of natives of India who are especially addicted to the vice. All 

 our cases, except one, belong to the middle and lower classes, and 

 we can safely take for granted that gluttony is a rarity, if not 

 absent, among these people. 



While in the standard textbooks on tropical diseases no 

 mention is made of the role of occupation in the causation of liver 

 abscess, it is of interest to note that 11 of our cases occurred 

 among laborers, 7 among clerks, 4 farmers, 3 soldiers and police- 

 men, 3 housekeepers, 2 fishermen, 2 laundresses, one each in a 

 driver, lawyer, and musician, one in a child, and two without 

 occupation. In connection with amoebic colitis, Deeks and 

 Shaw (28) point out that occupation is not an etiological factor, 

 except as it may bring the individual to a position or condition 

 where infected water is solely available for his consumption. In 

 view of this exposure to infection because of occupation, is it not 

 justified to assume that occupation is a factor? Farmers, fisher- 

 men, and laborers are the class of Filipinos nearest to nature, 

 and the kind of water available for their consumption is rarely 

 free from amoeba. As already stated, 17 of our cases occurred 

 among these classes of people. 



MORBID ANATOMY 

 NUMBER OF ABSCESSES 



The old observers always regarded amoebic abscess of the liver 

 as occurring singly. There is not the slightest doubt that 

 amoebic abscess of the liver may occur in multiple numbers. 

 Craig (18) describes cases in which the abscesses could be counted 



' An alcoholic beverage with about 19 per cent alcohol. 



