698 



THE LIVER. 



SB 



they were present at all, could have been by no means the main source of 

 the pus-corpuscles. 



Abscess sometimes forms in the liver, which is never made manifest by 

 noticeable symptoms the patient going on perhaps for years, and finally 

 dying from some other disease, or from some traumatic cause. This never 

 happens in multiple abscess of the liver in pyaemia, as the disease is generally 



rapid in its course, and death 

 its result. In a case of forma- 

 tion of abscess of the liver of 

 long standing, the abscess be- 

 comes encysted. The changes 

 leading to the formation of a sac 

 around the abscess have been 

 studied by myself, in a speci- 

 men in which a liver-abscess of 

 the size of a man's fist was 

 formed on the convex surface, 

 close to the peritoneum, which 

 was found transformed into a 

 tough pseudo-membrane of at 

 least 4 mm. in thickness, and 

 E G closely adherent to the dia- 

 phragm. 



Microscopic sections, made 

 through the pseudo-membrane 

 and the adjacent portions of the 

 liver, again illustrate the way in 

 which the pseudo- membrane, 

 membrana pyogena, had been 

 formed. It was very plain to be 

 seen that the interstitial con- 

 nective tissue of the liver and 

 the connective tissue of the 

 PCf peritoneum were broken down 

 into indifferent elements. The 

 epithelia of the liver were trans- 

 formed into medullary tissue in 

 exactly the same way which I 

 have described above, when 

 speaking of the formation of an 

 abscess. The difference was, 

 that in the latter instance the 

 medullary elements were left in 

 uninterrupted continuity. In 

 some places the medullary cor- 

 puscles became spindle-shaped, 

 and were partly transformed 

 into a basis-substance, that led to the formation of a delicately striated cica- 

 tricial connective tissue. The main mass of the medullary elements, how- 

 ever, had been simply transformed into a homogeneous or slightly granular 

 basis-substance, with rather scanty bioplasson bodies. Inclosed in this 



arc 



FIG. 311. DIAGRAM OF THE FORMATION 

 OF PUS FROM THE EPITHELIA OF A 

 LOBULE OF THE LIVER. 



LE, liver epithelia ; C, capillary Mood-vessel ; 

 SE, narrowed capillary, with swelled endothelia; 

 EG, coarsely granular epithelia, partly transformed 

 into multinuclear lumps ; MO, medullary corpus- 

 cles, sprung from both the epithelia of the liver 

 and endothelia of the capillaries, all interconnected ; 

 PC, pus-corpuscles. 



