dysentery; or by intercurrent disease, as pneumonia, pulmonary abscess, empyema, peritonitis. Recovery may also ensue 011 the abscess becoming encysted or, possibly, absorbed.
Rupture of the abscess.— Rendu, in a series of 563 instances of abscess of the liver, compiled from various sources, gives an interesting table showing the direction of rupture in 159 of the cases which opened spontaneously. This table may be summarized as follows:
| Rupture | occurred | into the | pericardium | in 1 | case | 0·13 | per cent. |
| Rupture„ | occurred„ | into the„ | pleura | 31 | cases | 5·5 | per cent„ |
| Rupture„ | occurred„ | into the„ | lung | 59 | cases„ | 10·5 | per cent„ |
| Rupture„ | occurred„ | into the„ | peritoneum | 39 | cases„ | 6·9 | per cent„ |
| Rupture„ | occurred„ | into the„ | colon | 6 | cases„ | 1 | per cent„ |
| Rupture„ | occurred„ | into the„ | stomach and duodenum | 8 | cases„ | 1·4 | per cent„ |
| Rupture„ | occurred„ | into the„ | bile-ducts | 8 | cases„ | 0·7 | per cent„ |
| Rupture„ | occurred„ | into the„ | vena cava | 3 | cases„ | 0·5 | per cent„ |
| Rupture„ | occurred„ | into the„ | kidney | 2 | cases„ | 0·3 | per cent„ |
| Rupture„ | occurred„ | into the„ | lumbo-iliac region | 6 | cases„ | 1 | per cent„ |
From this it will be seen that about 28 per cent, of liver abscesses rupture spontaneously, most generally into the lung or pleura.
Rupture into the lung.— If rupture takes place into the lung the abscess contents may be suddenly discharged, mouthful after mouthful of pus mixed with blood welling up or being coughed up. In a few instances, in such circumstances, death has occurred suddenly from the flooding of the lungs with pus. More commonly the discharge is effected gradually, a few drachms being brought up with each cough ; in the aggregate this discharge may amount perhaps to 5 or 10 oz. in the twenty-four hours. In favourable cases the daily amount expectorated gradually diminishes until all discharge ceases and the patient recovers. Frequently, however, a deceptive arrest of discharge and cessation of cough are followed by a rise of temperature, which had become normal on the occurrence of rupture. With this there may be a reappearance of the night sweats. In a few days cough and expectoration return as
