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CHAPTEE XL 

 SIMPLE HYPERTROPHY OF THE LIVER. 



THE third form of painless enlargement of the liver 

 is that known as "Simple Hypertrophy," by which 

 is meant a uniform enlargement of the organ, with 

 an increased size of the lobules and an increased 

 size of the secreting cells, without any alteration of 

 structure. The gland may attain two or three times its 

 normal size, without its form being essentially altered ; 

 it is hard, lacerable, and full of blood ; the acini are 

 enlarged, and of the normal reddish brown colour. 



The circumstances under which this increased growth 

 of liver takes place are somewhat obscure; but a per- 

 sistent (hyperaemia) determination of blood appears 

 under certain circumstances to favour the development 

 of enlargement of the organ. Hypertrophy has been 

 observed in cases where a portion of the liver has been 

 destroyed by some exudative process, the result of 

 syphilitic hepatitis, or from obliteration of the branches 

 of the portal vein. 



HYPERTROPHY has been found to exist with certain 

 forms of "diabetes mellitus." Frerichs, in 1849, 

 examined the liver of a man, aet. 44, who had died of 

 " diabetes mellitus," tubercles in the lungs, and 

 pneumothorax. He found the liver considerably en- 

 larged, its form normal, and outer surface smooth ; its 



