Hepatitis and hepatic abscess : their aetiology, diagnosis, and treatment / by G. Harrison Younge.

  • Younge, George Harrison.
Date:
1889
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Licence: Public Domain Mark

Credit: Hepatitis and hepatic abscess : their aetiology, diagnosis, and treatment / by G. Harrison Younge. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    often permanent, relief follows. During 18S3-84-85, acting on the recommendation of Professor Maclean, Surgeon S. J. Pennie, Army Medical Staff, and the writer adopted this treatment in a considerable number of cases, and found that it was practically free from risk, and gave excellent results. Under the term “hepatic phlebotomy ” Dr. George Harley recently recommended puncture in acute congestion of the liver, and claimed the credit of having introduced this treatment. {British Medical Journal, vol. ii., 1886.) The only thing that is new in the operation, however, is the name. In some cases of hepatitis all treatment fails, and sup- puration occurs. When this happens we should at once decide on our line of treatment, as delay may be fatal to the patient, and always diminishes his chances of re- covery. Previous to the introduction of antiseptic surgery operations on cases of hepatic abscess were so unsuccessful that Sir R. Martin, Morehead, Maclean, and others strongly condemned interference. They stated that an abscess of the liver should not be opened until distinct pointing, and redness of the skin, showed that it was about to burst of its own accord. And further, that when an abscess tended to open into the lungs or in - testines it should be allowed to do so, as these routes were more favourable for its evacuation than externally. Dr. Budd went even further than this. He stated that an abscess of the liver which pointed externally should be allowed to burst, as then slow inflammation caused adhesion between the two layers of the peritoneum, and shut off the peritoneal cavity from contamination ; while the pus escaped slowly through a small opening, thus preventing the entrance of air into the abscess cavity. In I860 Dr. Malcolmson, of Madras, recommended early operations, as he believed that the gangrene, which so often followed the opening of an hepatic abscess, was