CHAPTER XXXIV
ABSCESS OF THE LIVER
Definition.— A form of suppuration in the liver, occurring especially in warm climates, principally in male Europeans and in association with amœbic dysentery.
Geographical distribution.— Abscess of the liver, of the type known as tropical abscess, is, for the most part, a disease of warm climates. Usually a sequel, or, it may be, a concomitant of amœbic dysentery, it is rare or altogether absent in countries where this type of dysentery is also rare or absent. Its geographical distribution, therefore, is in the main regulated by that of amœbic dysentery. It has to be noted, however, that liver abscess is not a sequel or concomitant of the dysentery of all countries and at all times. Thus it is rare as an indigenous disease in temperate climates, even in those temperate climates in which dysentery is at times common enough. Again, in tropical climates the dysentery and liver abscess curves do not everywhere and at all times maintain a constant and definite relation to each other; for, even in hot countries, the dysentery of some places is more apt to be followed by liver abscess than is the dysentery of other places; and, even as regards dysentery in the same place, some epidemics are more apt to be associated with liver abscess than are others. Manifestly this apparent anomaly depends on the type of dysentery. On the whole, it may be laid down as a fairly general law that in the tropics and sub- tropics the liver abscess curve follows, in the main, the dysentery curve; and that the geographical range of liver abscess in these climates is the same as that of dysentery.
In Great Britain the liver abscesses met with occur most frequently in individuals who manifestly
