Analysis of fifty cases of hepatic abscess treated in the Seamen's Hospital, Greenwich, and the branch hospital, in the course of the last twenty-five years (1870-1895) / by W. Johnson Smith.

  • Smith, W. Johnson.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Analysis of fifty cases of hepatic abscess treated in the Seamen's Hospital, Greenwich, and the branch hospital, in the course of the last twenty-five years (1870-1895) / by W. Johnson Smith. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Autopsy. The liver abscess, which was a single one, had contracted to a very small cavity, and was almost quite healed. An abscess containing about 4 ounces of pus, found in left tempero-sphenoidal lobe, together with traces of basal meningitis. Case 48. (Under the care of Dr. J. Anderson).—Native of Jersey; A.B., aged 37 ; admitted December 28th, 1894, died January ist, 1895. Treated for severe and advanced dysentery of six weeks’ duration. Enlarge- ment of liver ; tenderness in right hypochondrium. Death from exhaustion. Autopsy: The liver much enlarged and rather pale; on section two, large hepatic abscesses wese opened in the right lobe. They were close together, but no communication between the two ; each of which was about the size of a cricket ball, contained a large quantity of sweet yellow thick pus, mottled with reddish-brown patches. The colon presented most extensive ulceration. The presence of hepatic abscess diagnosed during life, but the exhaustion of the patient too advanced to permit of surgical inter- ference. Reported by Dr. Windsor, House Physician. Case 49. (Under the care of Dr. Curnow).—*Lascar ; aged 42 ; admitted December 22nd, 1894, with effusion into left side of chest. Soon after admission, 16 ounces of straw-coloured fluid removed by aspiration. On January 14th, the presence of a liver abscess having been proved by puncture and aspiration, a portion of the 7th rib was resected, and a large cavity in the right lobe opened and drained. Notwithstanding free discharge of pus from this cavity, the temperature became irregular, and reached higher limits than before. The left pleural cavity was again filled with clear fluid, and soon after the operation on the liver, the patient had a severe attack of I dysentery, which lasted about ten days. After rectal injections of quinine, and the administration of ipecacuanha and opium, the temperature came down on February ist, and the patient made an almost uninterrupted recovery. During the acute stage of this case, the amoeba coli was found both in the dysenteric stools, and in the fluid discharged from the hepatic abscess. Reported by Dr. Windsor. Case 50. (Under the care of Dr. Manson, at the Branch Hospital).- Lascar ; aged 36 ; admitted April 29th, 1895, with dysentery and symptoms! of hepatic abscess. On May i6th. a portion of 8th rib on right side resected, and abscess on right lobe opened by Dr. Manson’s apparatus for puncture and free drainage. Recovery. Age. From 10 to 19 years of age (both numbers included) ... I 2 per cent. From 20 to 29 years of age ... 13 26 From 30 to 39 years of age ... 22 44 JJ From 40 to 49 years of age ... II 22 5) From 50 to 59 years of age ... 3 6 SO The youngest patient was 17 years of age. Of the three patients] between the ages of 50 and 59, one was 54, and two were 56. Case 49, Lancet^ 1895, Vol. I., p. 1109.