57 



and others less advanced stages of the 

 same process. 



1st. Aspect. 



These lesions have distinct outlines. 

 (Plate- 32, Fig. 1). They are round shaped and 

 coincide with the hepatic lobules, in the 

 centre of which is the efferent vein. 



Often two or three of these lesions 

 merge into one another, so that the out- 

 line of one or more of the contiguous 

 spaces disappears. 



They look then like a badly made 8, 

 or a roughly drawn bunch of grapes. In 

 each zone may be distinguished a central 

 spot and marginal ones. 



a) Central part 



The liver cells, blood corpuscles, capil- 

 lary endothelium and migratory cells be- 

 come necrotic. 



The trabecules of REMAK which can 

 be recognised, are decreased in number, the 

 cells which form them are deeply stained 

 by eosin, and become very distinctly outli- 

 ned, their granular protoplasm contains va- 

 cuoles, the nucleus is hardly seen or not at 

 all (karyolysis). 



It is easier to identify the cells by 

 their mutual relation than by their struc- 

 ture (Plate 32, Fig. 1). The capillary walls 

 are unaltered and show a clear outline. 



Between the capillary walls clearly out- 

 lined and the trabecules there is a clear space 

 where are found a few migratory cells and 

 spheric masses which eosin stains red, 

 and which are cellular detritus. 



The liver sinusoids are much enlarged 

 and very unequally. The lumen is occupied 

 by spherical vacuolated masses which do 

 not take eosin or hematoxylin stains, some 

 of them are blood and others migratory cells, 



In some of the areas of necrosis, one 

 or more capillaries are completely obstruct- 

 ed by bacilli. These thrombotic capillaries 

 are found more or less in the centre of the 

 lesion. 



The bacilli are Gram-positive, long, thick 

 straight or slightly curved. No capsule so 



spores were noticed. Unfortunately, no cul- 

 tures were made at the time of the autopsy; 

 it is therefore impossible to identify them. 

 They are very much like Bacteriiun-co 1 i 

 in appearance and staining properties. I also 

 found capillaries outside the area of necro- 

 sis in more or less well preserved hepatic 

 tissue, containing masses of bacteria with 

 the same characteristics. 



b) Margins 



The lesions just described are clearly 

 limited on the outside by a narrow zone of 

 tissue where the capillaries are very much 

 dilated and full of blood cells which stain 

 well with eosin ; round them are many migra- 

 tory cells and leucocytes with polymorphous 

 nuclei (Plate 32, Fig. 1). This narrow zone 

 serves as a dividing line or uninterrupted 

 frame which separates the necrotic degene- 

 rate areas from the neighbouring hepatic 

 tissues. The focal lesions just described are 

 often if not always surrounded by the fol- 

 lowing ones. 



2nd Aspect 



When observed with a low power, some 

 of the sections of this liver show zones 

 where the sinusoids are very much dilated 

 and full of blood corpuscles and liver cells 

 in which are seen signs of regressive chan- 

 ges. Some of these zones are small and 

 roimd. Most of them however form narrow 

 bands which are several times as long as 

 the microscopic field. 



The relations between diese lesions and 

 the hepatic lobules are not clear. The only 

 evident fact is that they are found far from 

 the portal spaces, from which they are se- 

 parated by a region in which the liver tis- 

 sue has retained its structure comparatively 

 well. This brusque contrast is one of the 

 best characteristics of the lesions. 



At the level of the above-mentioned 

 zones, the protoplasm of the hepatic cells 

 stains deeply with eosin; it is granular and 

 contains 2 or 3 larger vacuoles as well as 

 many small ones. The outline of the cells 

 ris very distinct. The nucleus of the cell oc« 



