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.

    18/22 (page 16)
    Note on the Amoeba Coli, by Dr. C. W. Windsor, M.A., House Physician. In this series of cases, the great majority belong to the class of “ Tropical Abscess,” which, however, as a specific organism has been described, would be more accurately called, “ Amoebic Abscess of Liver.” The frequent connection of hepatic abscess with dysentery has been com- pletely verified, but now one is able to attribute both affections to one common cause, viz., the Amoeba Dysenteriae or Coli. This organism belongs to the class of amoebae, and on the warm stage shews definite arnffiboid movements. It has a clearly defined outline of irregular shape, the commonest form being roughly oval, with a long diameter, more than twice the transverse diameter, the former varying from 50 to 70 per cent., and the latter from 20 to 30 per cent. In a carefully prepared specimen, a distinction can be made out between the outer and inner layers of the amoeba. The outer layer—ecto sarc—is quite clear, and completely invests the inner part, or endo sarc, which is of granular appearance. This is due to a number of vacuoles scattered through the protoplasm ; one, as a rule, being conspicuously larger than the rest. The nucleus is difficult to make out, but sometimes is very plainly seen. Most amoebae contain a large number of red blood corpuscles, some retaining their shape and pigment, while others appear as mere colourless discs, overlapping each other. In addition, there are numerous pigment granules scattered about the organism. Perhaps the most characteristic feature of these amoebae is the property of throwing out pseudopodia ; these are usually short, with blunt, rounded ends, and serve as a means of progression ; some, however, are thin and long, and may spread themselves out as to completely encircle the amcebae. On the warm stage the protoplasm may exhibit definite movements. The amoebae can be readily stained with logwood, and mounted as permanent preparations, which process, in many instances, brings out the large oval nucleus clearly and well. But in these mounted preparations, most of the amoebae are seen to be round in shape, and the pseudopodia are not visible. The amoebae are most abundantly found in the earlier specimens of pus withdrawn from the abscess cavity, which has been likened to anchovy sauce in appearance ; but in the later stages, when the pus has become yellow, they are not nearly so numerous. The pus from the true Tropical abscess is quite sterile, containing no pyogenic organisms, thus differing markedly from the pus derived from an abscess of pyoemic origin. In the diseased parts of the large intestine, the amoebae are most numerous in the opaque white mucus, so characteristic of amoebic dysentery, they have also been demonstrated in the floor of the ulcers, in the deeper layers of the intestinal walls, and rarely in the lymphatic tissue of the gut.