LIVER ABSCESS.
282
OPERATION. SECOND OPERATION 3 MONTHS
RECOVERY.
LATER.
A German, aged 43, was admitted on 23rd January, suffering from dysentery, fever and pain in right side. Stools contained blood and mucus but no Amabæ. Temperature chart was of an irregular remittent type. Liver dulness was much increased downwards and a rub was heard all along right base. Under salines the dysentery ceased in three days but as the hepatic symptoms continued, on the 29th January the liver war explored and an abscess found. This was incised and a tube (silver) inserted. Though the cavity drained well the temperature still ran a remittent course very suggestive of one or more other abscesses.
The patient being very weak no further exploration was attempted and the temperature finally fell to normal three weeks after the operation and did not rise again. The abscess healed without trouble. His weight increased from 9 stone to 10.10 and he was discharged on 31st March.
Re-admitted 9th April for 10 days suffering from alcoholism. The operation wound was quite firm and he had no liver symptoms.
Re-admitted on 28th April suffering from alcoholism, fever and pain on right side. The liver dulness was increased downwards with tenderness along the lower border of the ribs. The temperature ranged between 99° and 103° and there was a rub at right base. On May 10th the liver was again aspirated over the site of the previous incision and pus was found. The abscess was a very small oue and a tube was inserted. The temperature again kept up for five days but then fell to normal and the abscess rapidly healed and the patient was discharged on June 5th.
He was again in hospital on the 9th June suffering from his old complaint- alcoholism—and was discharged on the 17th having meanwhile as he gravely in- formed us signed the pledge.
Remarks. This is somewhat an unusual case and shows how much some patients can stand. He was very ill on both occasions when operated on and even in the alcoholic visits suffered badly. The case is interesting inasmuch as the first abscess seemed to be due to the dysentery, which was non malarial and non amoebic. Though dysentery is common enough here liver abscess is com- paratively rare more especially amongst Indians who, however suffer badly from dysentery.
Report on the Government Lunatic Asylums.
GOVERNMENT LUNATIC ASYLUMS,
HONGKONG, 13th February, 1905.
SIR, have the honour to forward you the Annual Medical Report on working of the Government Lunatic Asylums for the year ending December 31st, 1904.
I attach Table X, which shows the Admissions and Deaths during the year, and rable X the number of patients under treatment with an index of their diseases.
The total number of patients admitted to the Asylums was 166 as against 155 in 1903, which shows an increase of 11.
The following are the admissions for the past six years :-
.1899,
1900,
1901,
1902,
1003, 1904,
78
...109
90
.120
..155
..166
Owing to the increases of Europeans admitted, and to the increased average stay in the Asylums, the two European Females who occupied the upper floors of the European Block had in the early months of the years to be transferred to a cut-off ward in the Chinese Block adjacent the females. This relieved the con- gestion somewhat, as I was enabled to put all the chronic European male cases in the upper floor, and keep all the acute cases on the ground floor as more readily under the care of the Wardmaster on duty.
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