SYMPTOMS OF WAXY LIVER. 145 



This tabular arrangement clearly shows that the waxy, 

 lardaceous, or amyloid degeneration of the liver, like 

 scrofulous and tubercular affections, is more frequently 

 developed during the age of adolescence, than at any other 

 stage of life ; and it may further be observed, that with 

 few exceptions a waxy liver makes its appearance in 

 persons of broken-down constitutions, the result of other 

 morbid processes, and whose nutrition has been seriously 

 impaired by divers causes. 



SYMPTOMATOLOGY. The symptoms of a waxy liver are 

 not difficult of diagnosis. There is considerable enlarge- 

 ment of the organ, so large at times as to occupy a con- 

 siderable portion of the abdominal cavity, and extends 

 to the umbilicus or the groin ; the increase is uniform in 

 every direction ; the outer surface is smooth, and denser 

 than normal, and its lower margin is rounded, regular, 

 and free from all indentations. 



Waxy deposit in the liver has but little tendency to 

 obstruct the portal circulation, consequently ascites and 

 enlargement of the veins of the abdominal wall, and 

 jaundice are but seldom present. Pain and tenderness 

 are never prominent symptoms. The liver, as a rule, 

 can be manipulated with impunity, and the patient 

 complains only of a feeling of weight or tightness in 

 the right hypochondrium. The consequences which 

 follow waxy deposits in the liver are always of great im- 

 portance as regards the affected parts, because the organs 

 and tissues, so far as they are implicated in the disease, 

 lose their normal functions. 



The hepatic cells cease to take part in the formation 

 of sugar, and the secretion of bile ; the blood-vessels 

 also, when implicated in the mischief, lose their capa- 



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