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Liver Abscess.
This has been the cause of death in one case, namely, that of an unknown Chinese Female, aged about 36. The liver was uniformly much enlarged, and shining through the capsule of both lobes were numerous yellow patches, variable in size, and boggy on palpation. On section of the organ, the liver substance was found beset by numerous small typical abscesses of the liver.
Streptococci were found in the pus and walls of the abscesses.
There was no trace of old or recent dysentery.
Remarks. This case is interesting from the following points of view:--
1. It occurred in a Chinese Female.
2. There was no trace of Dysentery.
3. Streptococci were found in the abscesses
It is a difficult question to decide the etiology of such a case. A micro-orga- nism was found, namely, the streptococcus, but, had this organism to do with the production of the pus, or was its presence there, a secondary matter. There was no dysentery, in fact the alimentary canal was normal to the naked eve. Since the publication of my annual Report for 1903, I have been unable to devote much time to this disease and its etiology, but I trust, that in the near future, I may be able to go more thoroughly into the question.
Anencephalia.
Both children
Two monsters of this variety were found during the past year. were stillborn. In both cases, the part of the head above the forehead appeared as if removed The supra-orbital ridges become therefore the topmost parts of the skull. They make the eyes stick out, and give the face a characteristic frog appearance. Only the merest traces of brain substance could be found..
In both cases, the condition was present without retro-flexion, the vertebral canal being open only in the upper cervical region. Other malformations did not co-exist. Both children were females.
Hernia Diaphragmatica.
In both
During the past year 2 cases of this anomaly have been found. cases the children were stillborn. The defect in the diaphragm was in the left side in each instance. Through this the whole stomach had passed, along with the omentum, part of the colon, and a considerable portion of the small intestine. The heart was displaced towards the right. The right lung was fully developed ; the left, however, was only about one-third its normal size, its development having obviously been arrested by the pressure produced by the abdominal organs in the left thorax. The serons membranes of the peritoneal and thoracic cavities were continuous through the hernial opening.
According to ARMHEIM, about 400 cases of diaphragmatic hernia had been reported up to 1896. The condition is also found in animals. So far as the anatomical characters of condition go, the condition conforms to the general rules for such anomalies. They are not true hernias, in that there was no sac. Further, most authorities are agreed that the left side of the diaphragm is the seat of pre- dilection for such a condition, and to this rule my own cases form no exception.
Tumours.
During the past year a number of new growths have been examined. The majority of these have been sent to me for diagnosis by medical men in Hongkong and along the coast of China. A few cases, however, have been examined by me