MORADABAD CHARITABLE DISPENSARY. LIVER ABSCESS TKEATED BY ASPIRATION. By Surgeon R. G. Sanders, Civil Surgeon, Moradabad.

Janahur, aged fifty,

caste

Hindu,

came to

the dispensary

on

the 27th February 1878, with the following history and symptoms : States that four months ago, he went to Nani Tal; whilst there lie was attacked with fever which continued for three months in spite of treatment. He was much exposed to cold, and then dysentery supervened ; this lasted for some time, and as soon as it got better he noticed his liver began to swell; this has continued to increase up to present time accompanied with great pain, sense of weight, and difficult breathing. On examination, liver was found to extend below the umbilicus in front and nearly as low posteriorly, scarcely altered by change of position; fluctuation distinct; pulse weak, 110 ; very anoomic ; intense pain complained of below the ribs ; no pointing but an even uniform swelling occupying whole right side of abdomen ; breathing thoracic : constant cough with slight 'rust-coloured sputum ; face anxious; seemed to be almost at point of death. He was placed at once on operating table and the smallest trocar but once thrust through skin tightly stretched immediately below the ribs: on turning the stop cock, liquid reddish pus passed freely along the tube ; upwards of thirty ounces were drawn off: the pus then became darker coloured, and came very slowly notwithstanding the needle was passed in deeply. It was now withdrawn through a pad of carbolised cotton, a larger pad placed on and a bandage applied. A grain of opium was given and the man removed to the ward and put on milk diet. 28th. ?States that he feels better ; breathing easier; pulsa 96; feels hungry ; passed a good night; bowels opened once. March, ls?.?Feels pain at puncture, and on breathing no bad

symptoms. 6tk.?Bandage

removed ; liver quite small; its edge can be just below the ribs; no pain on pressure. Is hungry; pulse, temperature, etc., normal ; was found to be suffering

felt

a fistula in ano which was slit up. From this date his progress was uninterrupted and he was discharged on March 30th in good health.

from

Juse ], 1878.]

A MIRROR OF HOSPITAL PRACTICE.

was not given whilst, the liver was tapped, neither there any pain during tlie operation, nor faintnesa afterwards ; my opinion is that had tlie abscess not been aspirated the man would certainly have died in a few days ; the sudden cessation of all dangerous symptom* and the speedy cure are "Well worth noting.

Cliloroform

was

\ I

Mobadabad, April 8th, 1878.

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Liver Abscess Treated by Aspiration.

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