514 Howrah Hospital Report for 1846. 



increased vascularity, and is brittle and easily lacerable. In 

 cases of abscess it is common to find the liver in other parts 

 of a pale colour, both superficially and deeply seated. The 

 contents of abscess usually are pus with detached flakes and 

 sloughs of the organ, or else a dirty, thin, sanious, foetid, and 

 gritty liquid. 



With regard to the relation as cause and effect, of hepatic 

 abscess and dysentery, I am inclined to regard the two dis- 

 eases as contemporaneous or successive, although distinct, 

 products of similar causes, not as dependent the one upon 

 the other; for each is so often found to exist alone, and, 

 besides too, experience shows such to be the insidious nature 

 and course of hepatic abscess, that it may exist silently and 

 go on increasing without exciting recognition, and so may 

 have preceded the dysentery, although, after a complication 

 with dysentery, such a masking of both diseases can no longer 

 remain. Dr. Copland seems to take this view, allowing at the 

 same time the possibility of connection of the two diseases : 

 in one case, not complicated with dysentery, I found greenish 

 purulent contents in the hepatic veins, which appeared en- 

 larged and gaping upon incision into the liver. Of the pas- 

 sage of pus through the portal vessels from the bowels there 

 seems to be no doubt. The subject has been well summed 

 up by Dr. Budd in his work upon the relation between he- 

 patitis an4 dysentery. 



I have almost invariably found the liver closely adherent 

 to the diaphragm, and so to the walls of the chest, through 

 the medium of the peritoneum, and I believe the diaphragm 

 may be penetrated with perfect safety in opening abscess of 

 the liver. I am an advocate for an early opening into the 

 liver with a trocar, first dividing the skin with a lancet, 

 upon a well considered opinion of the presence of matter. 



Colic. — Several cases of this kind, of acute suffering, have 

 been admitted into hospital. Four cases have been admitted 

 from the same ship lying in dock, in September, within the 



