Studies in the life-cycle of human amoebiasis: from its protozoological, morbid, & clinical aspects (illustrated)
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Date
1917Author
Moses, John Gregory Owen
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Abstract
The Prognosis of Liver abscess cases, either with
or without attendant complications, self-induced
or otherwise, therefore depends almost entirely
upon the Method of Treatment employed. As has
been mentioned before, and which the detailed
cases emphasise , the clinical condition. of the
patient is sometimes less important than the
measures employed for their alleviation. The most
important consideration is the exhibition of
Ipecacuanha in full doses or its alkaloid Emetin
subcutaneously, in the pre-suppurative stage of an
Acute Hepatitis. Other factors which will
influence the Iortality rate e.g, the presence of
complications when the case first comes under
treatment, the number of abscesses present their
position, size & sterility, will be described
under Prognosis. The Tables arranged have been
chosen to illustrate the mortality aspect from
every point of view, and though. the Commentary
Notes appear rather as a criticism of post -
operative treatment, than actually reviewing the
gross mortality rates, yet mortality rate is
essentially wrapped up with the question of Open
Operation, and the less heroic procedures.
Evacuation through the three routes have been
compared and contrasted as influencing profoundly
the mortality rate. Such clinical facts as have
been presented by Rogers, have been gathered together
and re- quoted; so that the gross figures
themselves should be co- related with the clinical
state of the patients, so that some index may
accompany the dull recital of bare figures, and
have a direct bearing upon what has been termed
"The General & Surgical Mortality following
Liver Abscess ". In some cases of spontaneous
evacuati on taking place into the Bowel or through
the lungs, spontaneous cure results, so that
Nature's methods of evacuating amoebic abscesses
of the liver, are frequently entirely successful
in curing the patient, while they are far less
often accompanied by the extension of serious
inflammation to the Pleura or Peritoneum, or
septic infecti on of the abscess cavity, than are
the Surgeon's attempts in the same direction
(Rogers). Any method of treatment must always
be governed by the clinical condition and an
appreciation of the pathological state, combined
with the reaction of the system against such
state.