and here and there with streaks of a clear mucoid or yellowish material. It is so thick and viscid that it will hardly soak into the dressings; it lies on the surface of the gauze like treacle on bread, spreading out between the skin and the dressing, and finding its way past the edge of the latter rather than penetrating it. When quite fresh, here and there little islands of what may be described as laudable pus may be made out. in the brown mass. Sometimes it contains considerable pieces of necrotic tissue. Occasionally, from admixture of bile, the abscess contents are green-tinged. Liver purulage has always a peculiar mawkish odour; it is rarely offensive unless the abscess lie near the colon, in which case it may have a fæcal odour. Under the microscope many blood corpuscles are discoverable, besides much broken-down liver tissue, large granular pigmented spherical cells, leucocytes, debris, oil globules, hæmatoidin crystals, and, occasionally, Charcot-Leyden crystals and amœbæ; rarely the ordinary pyogenic bacteria.
Amœbœ, and pyogenic organisms.— According to my experience of tropical abscess of the liver seen in England, amoebae can be detected in considerably over half the cases. This agrees with Kartulis's experience in Egypt, and that of others elsewhere. Rogers concludes from a careful examination of scrapings from the walls of a large number of liver abscesses in Calcutta that the amoeba is always present. I have observed in a good many instances in which I have failed to detect the amœba in the aspirated liver pus, or in the pus which escaped at the time of operation, that the parasite appeared, often in great profusion, four or five days later in the discharge from the drainage-tube. I have seen them in these circumstances in strings of eight or ten; the string-like arrangement suggesting that they had developed in some tube, such as a blood- or bile- vessel. The amœbæ may persist in the discharge until the abscess has healed. It is justifiable to infer from the absence of amœbæ from the pus constituting what might be called the body of the abscess, and their appearance in the pus coming from the walls of the abscess a few
