516 Amyloid Disease of the Liver. 



Maximow with similar results and Davidsohn 's results with ral)bits, giunea pigs, 

 mice and fowls wore also positive. Lubarsch was able to i)rodu('e amyloid degenera- 

 tion in 3 or 4 weeks in rabbits and dogs by systematic subcutaneous injections of 

 oil of turpentine (suppuration!). 



The nature of the change in amyloid degeneration has not been definitely 

 settled up to the present nor has it been determined how the amyloid material, 

 which possesses some of the characters of proteins, is produced. It is not known 

 whether the material is elaborated in the liver or whether it is brought to the liver 

 by the blood. The former view appears to be the more probable, the theory being 

 that the cells are in a cachectic condition and are therefore una])le to deal with 

 the proteid materials, which are consequently left in the tissue spaces and become 

 converted into amyloid material (Wichmann). On the other hand the observations 

 of Noyer and Griiner indicate that amyloid degeneration is the result of injurious 

 effects exercised upon the tissue cells by certain poisons. 



Anatomical Changes. The liver is the organ that is most 

 commonly affected. In cases where the degeneration is ex- 

 tensive the liver may be enlarged three to four times. The 

 edges appear thick and ronnded, and tlie capsule is often con- 

 siderably thickened. The color varies from light l)rown to 

 yellow or gray. The lobulation is distinct because the periph- 

 eral part of each lobule is pale grayish-red and lardaceous, 

 the central 'portion being pale brownish-red, grayisli-l)rown, or 

 occasionally yellow. The consistency is more or less doughlike, 

 and in the later stages crumbling "like half-dried mortar. In 

 birds amyloid liver is granular and brittle. In the early stages 

 no abnormalities save slight enlargement, distinct lobulation 

 and pale color are observed. 



Amyloid material may be demonstrated in affected organs by its color re- 

 actions. The application of Lugol 's solution for a few minutes to the cut surface 

 stains the degenerated parts mahogany-brown. The same test may be applied to 

 microscoi>e sections, the color being changed to a dirty violet or bluish-red by the 

 addition of 2'/f sulphuric aci<l. Safranin gives an orangc-jellow color. 



In the horse the amyloid material is deposited in the outer zone of the lobules 

 and gradually extends inwards towanls the center. In this way the connection be- 

 tween adjacent lobules is soon destroyed and thus the softening of the organ is pro- 

 duced. The amyloid material is deposited in the walls of the capillaries and in the 

 intima of larger vessels. 



Symptoms. In cases where there is or has been some pri- 

 mary diseased condition which experience has shown is likely 

 to be followed by amyloid degeneration, a diagnosis of this con- 

 dition may be based upon the increased area of dulness in the 

 region of the liver and upon palpation of the liver. The symp- 

 toms are obscured by those of the primary disease, but as a 

 rule, such symptoms as anorexia, irregiilar defecation, dul- 

 ness, wasting and albuminuria, may be due to amyloid disease 

 itself. 



The disease is rarely associated with ascites or jaundice. 

 Eupture of the softened liver and resulting hemorrhage are 

 often observed whether there be any traumatic influence in 

 operation or not. In addition to anorexia and dullness, Eexante 

 observed an intermittent bright yellow coloration of the feces 

 which ^vere passed in small quantities only. The horse also had 

 slight attacks of colic and yellowness of the mucous membranes. 



