518 Rupture of the Liver. 



sometimes become calcified (Briickmiiller), or, after absorption 

 of the granular debris, converted into cysts with red-tinged 

 serous contents. On the other hand, old hemorrhages may be 

 indicated by fibrous cicatrices only. 



In -large hemorrhages, such as commonly occur in amyloid 

 livers, there is extensive breaking down of the liver tissue, 

 forming large cavities with soft irregular walls and containing 

 coagulated blood (hematoma). In such cases the weight of 

 the liver is increased. In a case reported by Trasbot the liver 

 of a horse weighed 33 kilogrammes. When the superficial lay- 

 ers of the liver tissue are broken through, the blood collects 

 under the serous covering and elevates it. In these cases, there 

 is a cavity filled with blood, immediately under the serous mem- 

 brane. By the bursting of such hematomata large quantities 

 of blood may be set free into the peritoneum. After extensive 

 hemorrhage either into the liver tissue or into the peritoneum, 

 there is evidence of severe anemia of all the other organs. 



Symptoms. Small hemorrhages into the liver tissue cause 

 no symptoms. If the hemorrhage is severe, symptoms of 

 internal bleeding are produced. The animal suddenly becomes 

 dull, it has an anxious expression, the pulse is accelerated and 

 weak, the mucous meml)ranes are pale and dry and the periph- 

 eral parts of the body are cold. Soon after, there is local 

 or general sweating, muscular tremors and staggering follow, 

 and finally the animal dies in from one to ten hours with con- 

 vulsions. 



In cases where the hemorrhage is not so profuse, the symp- 

 toms are less severe. In many cases the only abnormalities 

 observed are weakness, acceleration of the pulse, inappetence, 

 jaundice, slight constipation, stiffness of gait, susceptibility to 

 pressure over the liver or extension of the area of hepatic dul- 

 ness. The latter s^onptom has been observed by Weber in a 

 number of cases in the horse. In one particular case in a horse, 

 a hematoma in the neighborhood of the portal vein caused 

 marked swelling of the spleen. In some such cases there is im- 

 provement, at least for a time, in others, there is a sudden wast- 

 ing and death in five to six days. 



In a case lecorded by Dieckerhoff a horse lost so much blood that it was in- 

 cajjable of work for 3 or 4 months, but afterwards worked in a wagon for a year. 



In the eases recorded by Worz in which there were repeated hemorrhages, the 

 horses at first showed temporary digestive disturbances and slight abdominal pain. 

 Later there Avas anemia, dullness, wasting, edema of the legs, under surface of the 

 body and sheath. These symptoms were repeated with gradually increasing severity, 

 the dulness and depression became very pronounced, the feces were dry and mixed 

 Avith large quantities of imperfectly digested food and the urine was dark brown in 

 color. Finally the animals died in a state of complete exhaustion, if a rupture of 

 the liver did not supervene and kill them. 



Treatment. When there is a suspicion of hemorrhage of 

 the liver the most important factor in the treatment is abso- 

 lute rest. Ergotin^ extract of hydrastis or adrenalin may be 



