92 DISEASES OF THE LIVER. 



the usually coincident enlargement of the spleen, and, lastly, albumi- 

 nuria, when it exists, are important in the diagnosis of lardaceous 

 liver. By paying attention to these points, the higher grades of the 

 disease may be readily recognized. 



TREATMENT. It has not been proved, nor is it probable, that lar- 

 daceous degeneration is capable of restoration ; and, although cases 

 are said to have been observed where lardaceous livers have become 

 smaller and normal, further proof is needed on this subject before we 

 can believe the statement. The long-continued inunction of iodine 

 salve over the liver, although strongly recommended by Hudd, de- 

 serves little confidence. The preparations of iodine, particularly 

 syrupus ferri iodidi, are extensively used in lardaceous liver, as are 

 also alkaline baths and preparations of iron. Although these may not 

 improve the liver-disease, they may do much to arrest its progress. 

 Iodine justly holds the reputation of being a specific for tertiary syph- 

 ilitic affections, and in other dyscrasias also its beneficial effects have 

 been proved ; the preparations of iron are indicated by the great pov- 

 erty of the blood. The peculiarities of each case should decide which 

 of these remedies is to be employed. 



CHAPTER VIII. 



CANCER OP THE LIVER CARCINOMA HEPATIS. 



ETIOLOGY. The liver is so frequently affected with carcinoma 

 that, according to Rokitansky, there is about one case of cancer of 

 the liver to every five cases in all parts of the body, and Oppolzer 

 found it fifty-three times in four thousand autopsies, or in about 

 every eightieth patient. In many cases it is primary, in others it is 

 preceded by cancer of the stomach, rectum, or other organs ; it is pe- 

 culiarly apt to develop after extirpation of peripheral cancerous tu- 

 mors. 



The causes of carcinoma of the liver are just as obscure as those 

 of carcinoma elsewhere. It is true that, when asked, the patients are 

 rarely puzzled to tell what caused their disease, but their accounts 

 give us no true information as to its etiology. 



ANATOMICAL APPEARANCES. Medullary cancer is the form most 

 frequently found in the liver. It sometimes forms circumscribed, 

 sharply-bounded tumors ; sometimes it spreads out diffusely between 

 the liver-cells, and has no sharp borders. 



In the former case we find roundish or glandular and lobulated 

 tumors in the liver ; these are enclosed bv a delicate, vascular connec- 

 tive tissue capsule, and, where they touch the peritonaeum, are often 



