610 THE LIVER. 



is very common in Egypt and Abyssinia, occurring in the blood-vessels 

 of the liver. 



Pentastoma denticulatum is the undeveloped form of Pentastoma 

 teenioides, a parasite which inhabits the nasal cavity of dogs and some 

 other animals. In the liver of man it usually occurs in the form of 

 small, rounded, calcified cysts. The cysts may contain fat, calcareous 

 matter, and the remains of the dead parasite, among which the hooklets 

 may be found. 



Ascaris lumbricoides sometimes finds its way from the intestines into 

 the bile ducts. It may cause no disturbance here, but in some cases the 

 worms have been present in large numbers and caused occlusion, dilata- 

 tion, and ulceration of the biliary passages, and have led to the forma- 

 tion of abscess of the liver. 



Coccidium oviforme, the very common parasite in the rabbit's liver, 

 has been found a few times in the liver of man. 



LESIONS OF THE BILIARY PASSAGES AND THE GALL 

 BLADDER. 



Perforation and rupture of the gall bladder may occur under various 

 conditions and is usually followed by peritonitis. ' 



Catarrhal Inflammation most frequently involves the lower portion of 

 the common duct and the gall bladder. In the acute form it usually 

 leaves but few changes appreciable after death. An abnormal coating 

 of mucus, and sometimes congestion of the blood-vessels, are almost the 

 only post-mortem lesions. Owing to the swelling of the mucous mem- 

 brane and the accumulation of mucus iu the lumen, the ducts may be 

 temporarily occluded, but this occlusion may not be evident after 'death. 

 If, however, the inflammation becomes chronic, the walls of the bile 

 ducts may become thickened and their lumina more or less permanently 

 obstructed. In consequence of this, dilatation or ulceration of the bile 

 ducts may ensue. Temporary obstruction of the bile ducts may pro- 

 duce marked pigmentation of the liver, owing to the accumulation of 

 pigment granules in ths liver cells, particularly in the vicinity of the 

 capsule of Glissou, and jaundice of the entire body. 



The gall bladder may be inflamed by itself cholecystitis or in connec- 

 tion with inflammation of the biliary passages. If the disease is chronic 

 the wall of the bladder may be thickened ; polypoid growths may occur 

 in the nmcosa; the duct may be occluded; dilatation, ulceration, the 

 formation of gall stones, calcification, and atrophy may ensue. 



Inflammation of the stomach and duodenum, hypertemia and inflam- 

 mation of the liver, concretions, and parasites frequently accompany 

 catarrhal inflammation of the biliary passages, but it may occur without 

 these. 



Suppurative and Croupous Inflammation of the Bile Ducts (Cholangitis) 

 1 See Machard, Arch. gen. deMed., t. iv., p. 159, 1900, bibliography. 



