70 INFLAMMATION OF THE LIVER. 



however, encounter in this country two forms of In- 

 flammation of the Liver of considerable frequency, and 

 of far more importance than "suppurative hepatitis." 

 Of these, one terminates in simple or granular indura- 

 tion, known as cirrhosis, interstitial hepatitis, hob- 

 nailed liver, the nutmeg liver, but more familiarly 

 known at the London hospitals as the Gin-Drink er's 

 liver ; the other in softening and acute wasting of the 

 whole gland, whilst its history coincides, for the most 

 part, with that of malignant typhoid jaundice, slightly 

 referred to in the articles on those symptoms of hepatic 

 derangement. Inflammation of the Liver is a protean 

 disease, which is sometimes difficult to diagnose, and 

 sometimes difficult to treat, owing to the fact that the 

 individual parts only of that complex organ may be 

 affected, whilst the process itself may vary greatly in 

 intensity, extent, and result. Thus we may have 



1. Inflammation in the til>rous covering of the gland 

 (which is a ret lection of the peritoneum), or in the 

 sheath of the vessels, in "(ilisson's capsule," or in the 

 liile-duets, the glandular parenchyma, or the blood- 

 vessels (the portal or hepatic veins). 



2. The inflammation may invade the substance of the 

 organ as diffused hepatitis. 



3. As chronic inflammation, which is an insidious 

 form, ultimately terminating in cirrhosis, or the din- 

 Drinker's liver. 



4. The inflammation may restrict itself to a certain 

 radius, followed by abscess. This is the circumscribed 

 inflammation, terminating in abscess or the tropical 

 " hepatitis abscess " of some writers which shall receive 

 special notice in another chapter of this work. 



