tion. If it be deemed that there is another abscess, this should be sought for with the aspirator, and, if found, opened and drained. I have seen a patient recover after three abscesses had been so treated.
It is advisable to give emetine*[1] hypodermically, both before and after operation. Lately cases of liver abscess have been successfully treated by emptying the abscess by aspiration and injecting the cavity with emetine solution.
Treatment of abscess discharging through the lung.— In the case of abscess discharging through the lung, and, although emetine has been freely administered, not progressing favourably, the question of obtaining by surgical means more efficient drainage must be considered. There are two possibilities which render interference desirable: (a) Continued discharge of pus and blood, with or without attendant hectic; a condition which, if it persist, will, in all probability, in the end kill the patient. (b) Not infrequently prolonged discharge through the lung may induce fibrotic changes in that organ, or may give rise to pneumonia, or to abscess of the lung with all its attendant dangers, such as thrombosis or abscess of the brain. In these circumstances it is sometimes difficult to arrive at a decision as to whether an attempt should be made to open and drain the abscess, or to leave it alone. A large proportion of the cases recover, but at least an equally large number die. Of the latter, a proportion may certainly be saved by timely surgical interference.
In all cases of abscess discharging through the lung a careful register should be kept of three things —body temperature, daily amount and character of expectoration, and, once a week, the weight of the patient. If temperature keeps up, if the amount of pus continues the same or increases, or if the patient continues to lose weight, an attempt should be made at all risks to reach and drain the abscess from the
- ↑ * A case has been recorded of a patient who, refusing operation, was completely cured by emetine injections— 21 gr. being administered altogether; of another in whom the abscess burst into the lung and all discharge ceased on the administration of emetine.
