The Operations of Surgery (Jacobson) V.2

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I have previously pointed out, in connection with my method of treating amoebic liver abscesses by aspira- tion and injection into the cavities of soluble quinine salts, that such a plan should only be persisted with if the pus is free from marked secondary bacterial infection, as is the case in 85 per cent, in my experience." " Amoebic Liver Abscesses cured by Aspiration and Subcutaneous Injections of Emetine. In two other cases, one of which is still under observation, liver abscess pus was e...vacuated by aspiration and emetine injected subcutaneously, but not into the abscess cavity. In one the emetine injections were given for acute hepatitis, which greatly improved, but as leucocytosis persisted, the liver was explored and several ounces of pus withdrawn, after which steady convalescence ensued and the leucocy- tosis disappeared. In the other the emetine injections were commenced two days after the aspiration of liver pus, with an equally happy result.
A single aspiration so exceptionally cures such cases that these two suc- cessive recoveries are in all probability due to the action of the subcutane- ous injections of emetine in destroying the amoebae in the walls of the liver abscesses, so it may eventually prove unnecessary to inject the drug into the cavities ; although in view of the harmlessness of the procedure, and the certainty that it will kill the parasites in the superficial parts of the lining membrane, it is advisable to do so in the present state of our knowledge.


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