602 



THE LIVER. 



In other cases, particularly in children, there may be numerous 

 small gummata (so-called miliary gummata) (Fig. 130, page 258) scat- 

 tered through the liver, together with more or less new connective tis- 

 sue. In adults gummata are usually larger, varying in size from that of 

 a pea to a hen's egg, and may be surrounded by larger and smaller irreg- 

 ular zones of ordinary connective tissue (Fig. 366). In still other cases 

 in adults there are larger and smaller dense, irregular bands or masses 

 of connective tissue running through the liver, drawing in the capsule 



FIG. 367. SYPHILITIC HEPATITIS. 



The liver is greatly deformed by the contraction of new-formed connective tissue. The ragged surface is" 

 due to the tearing away of adhesions to surrounding parts. 



and often causing great deformity of the organ (Fig. 367). These bands 

 and masses of new tissue may or may not enclose gummata, either large 

 or small. These deforming cicatrices, either with or without gummata, 

 are very characteristic of syphilitic inflammation of the liver. 



This, like the simple interstitial inflammation of the liver, may be 

 associated with fatty and waxy degeneration, and with atrophy of the 

 parenchyma from pressure. 



Tuberculous Hepatitis. This lesion, which is usually secondary to 



