140 '^he Philippine Journal of Science i9i7 



Table VII. — Mortality in amoebic liver abscess by various observers. 



Observer. 



Cases. 



Country. 



Mortal- 

 ity. 



Rouis (1) . 



203 



125 



64 



292 





Per cent. 

 80 

 72.5 

 53 



60.1 

 73 

 31.5 . 



Castro (1) - - . 



Egypt 



Rogers (22). 



India 



Megaw (22) 





Rogers (22) 



52 

 38 



India 



Abriol 



Philippines- - _. _ , 







We note that the mortality among the 38 cases of Filipinos 

 is relatively low, in spite of the fact that most of our cases 

 come under observation at a very late stage of the disease and 

 many of them are not by any means in a favorable condition 

 for surgical intervention. It is hoped that with the growing 

 popularity of operative procedures among the natives we will 

 be able to reduce the death rate to a very low minimum. 



TREATMENT 



When the diagnosis of amoebic hepatic abscess is definitely 

 established, the treatment resolves itself into various methods 

 of surgical procedure. These range from a simple aspiration 

 and injection with quinine to freely opening and draining the 

 abscess. 



ASPIRATION AND INJECTION OF QUININE WITHOUT DRAINAGE 



Rogers in 1902 was the first to suggest aspiration and in- 

 jection of quinine without drainage. Later Wilson, (34) Spen- 

 cer, (34) 0'Kenealy,(34) and Stevens (34) reported favorable re- 

 sults from this procedure. Rogers (22) describes the technic as 

 follows : 



In carrying out this plan of treatment the following points require 

 attention. The skin at the seat of puncture must be most thoroughly 

 sterilized to prevent any bacteria being carried into the cavity. If the 

 presence and position of the abscess are accurately known a full sized 

 aspiration trocar should be used to allow as much as possible of the thick 

 pus being withdrawn through it. For the same reason it is also an ad- 

 vantage to use a T tube of large calibre fitting into the exhausted bottle. 

 Messrs. Down Bros, have made a suitable one for me. The cavity is 

 emptied as far as possible, some of the first pus being run directly into 

 a sterile test tube for bacteriological examination. A previously boiled 

 solution of the very soluble bihydrochlorate of quinine, of a strength of 10 

 grains in 1 oz. of water, is now injected into the abscess cavity through the 

 cannula by means of a sterile syringe, and the cannula is then withdrawn 



