522 Acute Yellow Atrophy of the Li-er. 



■ficans, the condition is not dne to cystieerci or distomes as supposed by 

 Seiler and Wolffhiigel. l^riidel also points out that the hepatitis may 

 be connected in some way with swine fever. 



Literature. BrJidel, Ein Beitr. z. Keuntii. d. Leberkrankh. d. Schweiiies. Diss. 

 Giessen, 1908 (Lit.).— Kleinpaul, B. t. W., 1907, 101.— Nonewitseh, Cbl. f. Bakt., 

 1888, III, 233; O. M., 1890, 440 (Eev.).— Seiler, D. t. W., 1907, 436.— Senimer, O. 

 Vj., 1874, XLI, 136.— Willerding, Pr. Yb., 1908, II, 58.— Wolffhiigel, Z. f. Infkr., 

 1907, II, 546. 



7. Acute Yellow Atrophy of the Liver. Atrophia hepatis flava. 



Etiology. Poisoning l3y certain substances, such as phos- 

 phorus and hipinose (Schneidemiihl), is followed by a sudden 

 and extensive fatty degeneration associated with destruction 

 of the liver cells. This destruction of tissue leads to a reduc- 

 tion in the size of the organ. The same cause is probably 

 in operation in those cases whicli have come under observation 

 following the ingestion of sour potato peelings (Haubner), pea 

 or vetch straw (Reinemann, Jansen), and green vetches 

 (Stohr). Occasionally, such cases occur without a discoverable 

 cause. In some cases the coincident existence of septicemia or 

 gastro-enteritis suggests the possibility of a toxin being the 

 cause. In other instances poisons contained in the food may be 

 responsiljle. Haul)ner and Franze saw cases following the use 

 of hay from flooded land. 



The disease has been observed principally in the horse 

 and sheep. Callot records an epizootic among cattle in Uru- 

 guay. 



Anatomical Changes. The liver is reduced in size, corru- 

 gated, very soft and ochre-yellow in color. The cut surface 

 from which a large quantity of fatty debris can be scraped, 

 shows at places somewhat firmer red areas in which the liver 

 cells are for the most part destroyed, and the vessels are di- 

 lated. Besides a cellular infiltration of the liver tissue, the 

 epithelium of the bile ducts appears in some cases to be degen- 

 erated, while the smallest bile ducts have proliferated. There 

 is fatty degeneration of the kidneys. At the postmortem, there 

 may also be found enlargement of the hanphatic glands; and 

 of the spleen, catarrh of the stomach and intestines and hemor- 

 rhages in other organs. 



Symptoms. The onset of the disease is marked by sudden 

 depression and weakness, fever, jaundice of the mucous mem- 

 branes, inappetence and, in some cases, attacks of colic with ten- 

 derness of the abdomen (Zundel). In the later stages there is 

 diarrhea. The jaundice and dullness soon become very marked, 

 but at intervals there are sjanptoms of excitement. 



As a result of the coincident disease of the kidneys, the 

 urine is diminished in amount, reddish-brown in color and con- 



