728 THE EE8PIEATOEY TRACT. 



color, firm, and only slightly crepitant on pressure, the upper lobes being the 

 most firm. Numerous small, subpleural ecehymoses were observed scattered 

 over the surface of both. An attempt to inflate the lungs with a blow-pipe 

 only partially succeeded. There was no evidence of pleurisy. The heart was 

 normal. The abdomen was large and rounded, dull on percussion over 

 nearly its entire surface, and a large, solid body filling most of its cavity could 

 be felt through the abdominal walls. On section this body was found to be a 

 ponderous liver. A small area of the lower anterior surface of the right lobe 

 had become attached to the abdominal walls by recent inflammation. About 

 six ounces of a dark straw-colored fluid containing a few whitish flocculi were 

 found in the abdominal cavity. The spleen was of normal size and firm. The 

 kidneys presented nothing abnormal in gross appearance. No other organs were 

 examined. The liver and lungs were placed in a solution of chromic acid. 



Liver. After the liver was sufficiently hardened for microscopical section, 

 a more careful examination of its gross appearance was had. It was then 

 observed that its great volume was largely due to the increased thickness 

 of the right lobe. A cup-shaped depression, three-quarters of an inch in 

 diameter, was observed on the dorsal surface of the right lobe. The 

 cystic duct was so dilated that it formed, with the gall-bladder, a continuous 

 pouch to its junction with the hepatic duct. The caliber of the hepatic and 

 common ducts was also much enlarged. The liver in transverse sections 

 exhibited numerous cysts, occupying more especially the central portions of 

 the organ, while the periphery, to the depth of from one-quarter to one-half 

 an inch, was comparatively normal. These cysts varied in size from a 

 pin's head to that of a filbert, and so closely approximated one another in 

 certain portions as to give to those parts a close resemblance to a coarse 

 sponge. The cup-shaped depression above referred to proved to be part of 

 a large collapsed cyst near the surface. 



Under the microscope, with a power of two hundred diameters, the .liver- 

 tissue showed marked features of syphilitic hepatitis. Crowds of inflamma- 

 tory corpuscles were found filling not only the inter-lobular connective tissue, 

 but also, in many places, the interior of the lobules themselves, thus render- 

 ing the boundary line between them indistinct. With a power of six hundred 

 diameters, the liver epithelium in many places seemed to be transformed into 

 globular or slightly angular medullary corpuscles. Such bodies filled, also, a 

 number of inter-epithelial capillaries, being marked in these situations by an 

 arrangement in rows, and also by the absence of the brownish liver tint. In 

 some epithelia containing an unusually large nucleus there were observable 

 several concentric, circular rows of small granules. Only a few capillaries 

 held red blood-globules. All of the inflammatory corpuscles, more particu- 

 larly the concentrically granulated bodies, exhibited a peculiar luster and a 

 homogeneous appearance characteristic of waxy degeneration. The re-agents 

 --methyl aniline, picro-indigo, osmic acid, and iodine yielded only nega- 

 tive results. This may have been due, however, to the effect on the tissues 

 of the chromic acid solution. Cysts, too small to be seen with the unaided 

 eye, were observable, and some of the larger ones contained bacteria. (See 

 Fig. 327.) 



Lungs. Specimens selected from the more diseased parts showed a very 

 marked augmentation of the interalveolar connective tissue. Some of the air- 

 cells were considerably distended by the previous inflation ; others corre- 

 sponded to the appearance of the normal foetal lung, and were onlyrecogniza- 



