THE LIVER. 593 



body, chiefly in the liver, spleen, and marrow of the bones. In the liver 

 it is usually found enclosed in the endothelial cells l free or in place in the 

 blood-vessels (see Fig. 359), but sometimes in the tissue between them. 

 The liver cells frequently contain bile pigment, but usually are free from 

 the melauotic pigment characteristic of this malarial condition. As the 

 result of this accumulation of pigment the liver may have a dark reddish- 

 brown, an olive-brown, or black color (sometimes called bronze liver). 

 Pigmentation of the liver may be marked in hsemochromatosis (see 

 p. 88). 



Pigment similar in character to that which occurs in the lungs from 

 the inhalation of coal dust may be found in the connective tissue along 

 the portal vessels. Inhaled pigment particles may pass the lungs and 

 bronchial lymph-nodes, and be deposited in the liver as it is in the spleen 

 and hepatic lymph-nodes. 



Pigmentation of the liver cells, which is to a certain extent normal, 

 may be greatly increased as a result of atrophy, of localized haemorrhage, 

 and of obstructive jaundice. 



CALCIFICATION. 



This lesion of the liver is rare. The deposit of lime may be in the 

 vicinity of the arteries or the veins." 



INFLAMMATION. (Hepatitis.) 



Acute Exudative Hepatitis (Purulent Hepatitis). Purulent orsuppura- 

 tive inflammation of the liver may be the result of injury; it may be 

 secondary -to inflammation of the gall ducts or the branches of the portal 

 vein. It may occur as the result of the presence of tumors and parasites, 

 or from propagation of an inflammatory process from without, as in ulcer 

 of the stomach with adhesions to the liver and secondary involvement of 

 the latter. It is often directly due to the introduction of bacteria into 

 the organ, through the blood-vessels or gall ducts or otherwise. Puru- 

 lent inflammation in the liver almost always results in abscess. 



Large abscesses of the liver may be traumatic, but are often due to 

 unknown causes. They are not infrequently associated with dysentery, 

 and may then be due to the conveyance of micro-organisms through the 

 veins, or lymph channels, or peritoneum, or gall ducts from the intestinal 

 ulcers. Such abscesses may be due to the presence of the amoeba coli. 

 They occur most frequently in tropical climates hence the name tropical 

 abscess but are not very uncommon in the temperate zone. They are 

 usually single, but there may be several of them. They are sometimes 

 so large as to occupy a large part of the lobe. They are most frequent 

 in the right lobe, but may occur in any part of the organ. They tend to 



1 For a study of the phagocytic powers of the endothelial cells of the blood-vessels 

 of the liver see Heinz, Arch. f. link. Anat., Bd. Iviii., 1901, p. 576. 



2 See Brill and Libman, Jour. Exp. Med., vol. iv., p. 541. 



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