PATHOLOGY OF CIRRHOSIS. 103 



The countenance becomes sallow; there is general languor 

 and depression of spirits, flatulence, an irregular action 

 of the bowels, sometimes costive, sometimes relaxed, 

 sometimes pale and clayey, sometimes dark, with a faint 

 jaundiced tint of the skin and conjunctivae. After a 

 longer or shorter duration these symptoms may abate, 

 although the disorganizing process may still go on in 

 the liver, and gradually undermine the constitution; 

 consequently, these symptoms, however trivial they may 

 appear to a casual observer, ought not to be treated 

 lightly, especially when present in a patient known to 

 be fond of his DRAMS, one of the most prolific causes 

 of cirrhosis of the liver. 



Not unfrequently the disease may set in with symp- 

 toms of a more severe and prominent character, and 

 which commence with vomiting and purging, and other 

 symptoms of intense " gastric catarrh." At other times 

 we encounter all the phenomena of acute congestion 

 of the liver, viz,, fever coupled with pain, tenderness, 

 and enlargement of the organ, with nausea, vomiting 

 jaundice, and high-coloured urine, containing bile- 

 pigment and a heavy deposit of lithates. Such is a 

 brief outline of the leading symptoms generally encoun- 

 tered in the first or early stages of cirrhosis. 



ANATOMO-PATHOLOGICALLY. We find in this stage the 

 liver enlarged and increased in consistency, caused by a 

 sted or hypertrophied condition of the areolar 

 framework, (Glisson's capsule). The surface of the 

 organ is covered by a smooth, opaque, thickened capsule, 

 studded with flattened projections, which vary in size 

 from a pin's head, a homoeopathic globule, to a small pea : 

 similar nodules are also found in the interior of the 



