CHRONIC ATROPHY OF FRERICHS. 113 



cases the capsule becomes thickened, and is often con- 

 nected to surrounding organs by firm bands of fibrous 

 tissue ; similar bands also pass into the interior of the 

 organ, which on pressure presents a dense, smooth, uniform 

 surface, with the outlines of the "lobules" more or less 

 obliterated. This condition of liver is recognised by 

 some writers as " simple induration," and is not unfre- 

 quently met with in patients suffering from the secondary 

 and tertiary forms of typhilis valvular disease of the heart 

 of long standing, inflammation of the pleura, ulceration of 

 the stomach and duodenum, and various derangements of 

 the secreting tissues of the liver itself. In such cases 

 the inflammation is sent to the capsule of the liver 

 through the diaphragm, along the coronary ligament, 

 or from the subjacent glandular structures. When the 

 disease has a syphilitic origin the surface of the con- 

 tracted liver is marked by cicatrices, or deep and irregular 

 fissures. Under other circumstances the surface is 

 smooth, and totally devoid of those granulations or 

 hobnailed protuberances which, so characteristically 

 mark true cirrhosis. 



The chronic atrophy of Frerichs or the red 

 atrophy of Rokitansky. This form of atrophy is 

 distinguished from all others by its dark-brown or 

 bluish red colour: the substance of the organ is 

 d with blood, and presents a spongy, elastic con- 

 iice ; there is an absence of granulation, and a 

 section gives an appearance of a perfectly homo- 

 geneous texture : the secreting cells are smaller than 

 natural, and loaded with brown pigment granules. 

 The atrophy of the organ is general, though its thick- 

 ness preponderates over the dimensions. The other 



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