XII, B, 3 Abriol: Amoebic Abscess of the Liver 133 



abscess; Rogers (22) places the type of fever as remittent in over 

 half of the cases; one seventh, high continued, keeping above 

 101° F. and varying more than two degrees in the twenty-four 

 hours; in one fifth, the temperature was intermittent; and in 

 2 out of 57 cases it was normal. While all authors agree that 

 some liver abscesses of the amoebic type at times present no 

 fever, data as to the percentage of the cases in which this exists 

 is not forthcoming except in Rogers's cases cited above. Our 

 Filipino cases of 4 with normal temperature out of 38 cases 

 probably represent the true proportion among the Filipinos. 



PULSE 



The pulse varies according to the degree of temperature 

 present, increasing directly in proportion with the fever, 



RIGORS 



In older descriptions of amoebic liver abscess, rigor is given 

 much prominence. Eleven of our cases gave a distinct history 

 of rigor. This, as a rule, occurred in our cases toward evening 

 as a mild chilly sensation, never so severe as that found in 

 malaria. Slight fever follows it. 



SWEATING 



Rogers (22) and Manson(i) emphasize the presence of copious 

 sweats and state that it may be so abundant as literally to drench 

 the patient's clothes. This particularly occurs when the patient 

 sleeps. In our series four had sweats to a moderate degree, three 

 of the cases were among those who had rigors, and the perspira- 

 tion occurred immediately after the chill. 



VOMITING 



In regard to vomiting, very little attention is given to it by 

 many observers. Manson(i) attributes it to pressure on the 

 stomach or a catarrhal condition of that organ. In our cases 

 twelve gave symptoms either of nausea or vomiting. 



PAIN 



As to the typical description of the pain referable to liver 

 abscess, Manson(l) says: 



There are several types of pain — local and sympathetic — associated with 

 liver abscess. Complaint is almost invariably made of a sense of fulness 

 and of a sense of weight in the region of the liver, not unfrequently 

 referred to the infrascapular region. Stabbing, stitch-like pain, increased 

 by pressure and especially by deep inspiration, by coughing and all sudden 

 jarring movements, is very common, and probably indicates perihepatitis 

 from proximity of the abscess to the surface of the organ. Percussion, 

 or firm palpation, especially if practised during deep inspiration and below 



