Anatomical Clianges. SyniDtoms. 527 



distribution of tlie portal vein (Sclmmann). In recent cases the 

 liver tissue is in a condition of parenchymatous or fatty de- 

 generation, but in cases of longer standing the abscesses are pro- 

 vided with walls of fibrous tissue and the surrounding liver 

 tissue is traversed by strands of fibrous tissue. In other words, 

 the lesion is one of chronic interstitial hepatitis. The superficial 

 abscesses project above the level of the liver tissue and fluctu- 

 ation can be felt. The serous membrane of the liver may be cov- 

 ered with fibrin or thickened. 



For various reasons the abscesses are usually few in num- 

 ber, and when due to an injury there is, as a rule, only one. In 

 such cases the abscesses may attain an enormous size. Felisch 

 reports one in which the abscess measured 20 cm. in its greatest 

 diameter. Al)scesses of this size project above the surface of 

 the liver and are usually adherent to the diaphragm, or possibly 

 to the stomach or large intestine. In rare cases rupture of such 

 an abscess causes a suddenly fatal peritonitis. 



In the liver abscesses of an ox Grips found the bacillus pyogenes bovis. 

 Kiinnemann repeatedly found the necrosis bacillus and Lisi found staphylococci 

 in the abscesses in the livers of lambs. According to Schumann omphalogenous 

 abscesses in calves are caused by various bacteria but especially by streptococci 

 and staphylococci. In other cases he found colon bacilli and the bacillus pyocyaneus. 

 The abscessdike necrotic foci are caused by the necrosis bacillus. (Biirgi has described 

 a purulent hepatitis of the hare that is due to a staphylococcus.) 



According to Stubbe an abscess on the anterior surface of the liver some- 

 times elevates Glisson's capsule and becomes adherent to the diaphragm, the extent 

 of the adhesion gradually extending until the abscess wall loses its connection with 

 the liver and remains attached to the diaphragm, the convexity of the liver show- 

 ing a depression corresponding to the position of the abscess. 



Symptoms. Single and, occasionally, numerous small ab- 

 scesses may produce no noticeable symptoms, or at most, a 

 certain amount of wasting. In other cases suppurative hepatitis 

 is a complication of another disease, and thus the symptoms to 

 which it gives rise are completely ol^scured. It is only in rare 

 cases that a moderately rapid process of abscess formation in 

 the liver causes visible sjanptoms. In addition to disturbances 

 of digestion, there may be persistent fever of no particular type, 

 or there may be simply occasional elevations of temperature. 

 An increase in the amount of indican in the urine is demon- 

 strable. These symptoms are indicative of some internal sup- 

 purative process ; the more or less pronounced jaundice, and the 

 presence of bile pigments in the urine point to suppurative hepa- 

 titis (Smith). 



In the dog and ruminant enlargement of the area of hepatic 

 dulness has some diagnostic importance, as has also swelling 

 in the hypochondriac region in the former. In all animals there 

 is pain on pressure over the hepatic area. According to Mouil- 

 leron and Chauffart, hepatic dulness can be discovered in the 

 horse in some cases. In cattle there may be symptoms of trau- 

 matic gastritis (indigestion, shallow respiration and groaning 



