Howrah Hospital Report for 1846. 513 



walls, &c. Out of five cases that I have operated upon for 

 the relief of abscess of the liver in and out of the hospital, 

 in two only has success attended, leading me to infer that 

 in these two cases happily there had existed but one abscess, 

 the early emptying of which had relieved the irritated system 

 and left nature free to repair the lesion of the organ. In a 

 great many other cases that have come under my notice, post 

 mortem examination has almost invariably discovered two or 

 more collections of pus, or else one large bag, the result of 

 the destruction of a large portion of the liver, and often nu- 

 merous small abscesses have been found in the organ scat- 

 tered throughout both lobes, of the size of several peas each 

 or of a walnut. The abscesses are found in all positions and 

 directions, tending towards the front, or towards the back, or 

 side, or in the direction of the lungs and other viscera. As 

 often as not, there is no defined bulging, although the side, as 

 a whole, is generally perceptibly enlarged. In notes that I 

 have of more than twenty cases, I have only mention of one 

 case where any thing like a cyst was found, and in that, in one 

 only of two associated abscesses, a semi-cartilaginous lining 

 to the abscess was found with a rough secreting yellow-white 

 surface, contents healthy pus. More commonly upon post 

 mortem examination of abscess of the liver, the walls are 

 found ragged and shaggy, formed out of the substance of the 

 liver, which is breaking down and undergoing conversion 

 into pus, by a combined process of degeneration and death of 

 structure and of ulcerative absorption ; again, the immediate 

 walls of the abscess are often white and devoid of blood, and of 

 a basket-work appearance from interstitial absorption ; or in 

 other cases the walls of the abscess may be described as com- 

 posed of the usual substance of the liver, heightened in colour 

 by increased vascularity, at the same time softened and brit- 

 tle in texture, and interspersed with minute white spots of 

 deposited matter, these having the appearance sometimes of 

 atoms of suet. Skirting abscess, the liver usually displays 



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