THE LIVER. 591 



Microscopically the liver cells are seeii to contain larger and smaller 

 droplets of fat (Fig. 310), and frequently large drops of fat occupy nearly 

 the entire volume of the cell, so that the protoplasm may be visible only 

 as a narrow, nucleated crescent at one side, or it may disappear alto- 

 gether (Fig. 311). 



Fatty infiltration of the liver may occur as a result of excessive in- 

 gestion of oleaginous food ; in chronic alcohol, phosphorus, and arsenic 

 poisoning ; in certain exhausting diseases accompanied by malnutrition, 

 as in pulmonary phthisis, chronic dysentery, etc. ; and under a variety 

 of conditions which we do not understand. It is common in children 

 especially in acute infectious diseases. ' 



Fatty Degeneration. In this condition, which In many cases cannot 

 be morphologically distinguished from fatty infiltration, the fat is be- 

 lieved to be formed by a transformation of the protoplasm of the liver 

 cells. The fat droplets are, for the most part, very small and abundant, 

 though this is not constant. Fatty degeneration of the liver cells fre- 

 quently follows, and is associated with, cloudy swelling under the vary- 

 ing conditions in which this occurs, or it may appear in profound anemia 

 and in acute phosphorus and arsenic poisoning. 



Amyloid Degeneration. In the liver amyloid degeneration may be 

 general or local ; so extensive as to give the organ very characteristic 

 appearances, or so slight as to be unrecognizable without the aid of the 

 microscope. It may be associated with other lesions. When the change 





FIG. 358. AMYLOID DEGENERATION OF LITER CAPILLARIES. 



The capillaries are much enlarged and occluded by the amyloid material ; the liver cells between them are 



atrophied. 



is extensive and general the liver is enlarged sometimes to more than 

 twice its normal size ; the edges are thickened and rounded ; the surface 

 is smooth; the tissue tough, firm, inelastic, more or less translucent, and 

 of a brownish-yellow color. The lobular structure may be more or less 

 indistinct, or it may become very evident by an associated fatty degen- 

 eration of the peripheral or central cells of the lobules. The translu- 

 'See Freeman, Archives of Pediatrics, vol. xvii., p. 81, 1900. 



