A bulging having been found, that part of the liver which apparently overlies the abscess should be stitched up to the sides of the opening made in belly-wall, and should then be explored by a hollow needle.
On his journey he was upset from his carriage, and the accident caused an internal abscess which was never cured.
But the necessity of the connexion is also apparent, unless we are to suppose that, as regards the course of universal nature, man is altogether an imperium in imperio, or rather (to adopt the forcible phrase of Marcus Aurelius) an abscess or excrescence on the nature of things.
In other cases gall-stones set up irritation in the gall-bladder which runs on to inflammation, and the gall-bladder being infected by septic germs from the intestine (bacilli coli) an abscess forms.
It is inadvisable to explore for a suspected abscess with a hollow needle without first opening the abdomen, as septic fluid might thus be enabled to leak out, and infect the general peritoneal cavity.
If the abscess be deeply situated in some tissue and not able to open on to a free surface so allowing the contents to be drained off, the phagocytic cells play a very prominent part in the resolution of the abscess.
Then they develop .definite fibrils which differentiate into fibrous laminae forming a zone which shuts off the abscess from the healthy tissue and so prevents the further invasion and injurious effects of the microorganism.
One of the severest complications of the disease is abscess of the liver, usually said to be solitary, and known as tropical abscess of the liver, but probably is more frequently multiple than is usually thought.
If the abscess is allowed to take its course, adhesions may form around it and it may burst into the intestine or on to the surface of the abdomen, a biliary fistula remaining.
Sometimes the abscess declares itself by a bulging at the surface, but if not an incision should be made through the belly-wall over the most tender spot, and a direct examination of the surface of the liver made.