190 
congestion is also frequently present, and tinges 
the substance of tg Tith a variable hue 
of yellow, green, &c. Portal observes that the 
liver of patients who have died of scurvy is 
often so much softened that it appears in a 
State of decomposition, has a reddish brown 
colour, and resembles the lees of red wine. 
Baillie remarks that sofiening of the liver is 
not uncommon in old persons, that it a 
proaches in consistence to the texture of the 
spleen, and is ofa brownish red colour. 
e. Induration of the liver is occasionally 
attendant upon hypertrophy or atrophy of the 
organ, but it may also exist with a normal size 
of the liver without other rs agers change than 
the brownish red tint which it receives from 
venous congestion, or the various shades of 
yellow, green, or brown induced by biliary 
congestion. The density and hardness acquired 
by the liver in a state of atrophy are sometimes 
truly astonishing. In a case detailed by Mor- 
gagni the organ resisted the knife, and several 
such instances are to be met with among the 
writings of the older pathologists. 
J. Fatty degeneration of the liver—Upon 
referring to the section upon the chemical 
analysis of the liver, it will be observed that a 
certain proportion of oily matter is one of its 
natural constituents. Under the influence of 
diseased action this quantity is greatly aug- 
mented, and increases to such an extent as 
completely to take the place of the normal 
structures. Vauquelin has published an analy- 
sis of a fatty liver, from which the quantity of 
oily matter present may be fairly estimated 
thus; in 100 parts he found, 
| eeeoeee seed ee 45 
Parenchyma ........ 19 
Water or eee sere eeeee 36 
100 
The fatty matter is usually distributed equally 
through the organ, being apparently infiltrated 
into the cellular texture of the parenchyma. At 
other times it is deposited in a mass or forms se- 
veral collections in different parts of theliver. The 
fatty liver 1s greasy upon the surface, and when 
cut into has the appearance of a section of 
yellow soap. The vessels seem pressed upon 
and are scarcely perceptible, while the 
deposition is divided into angular masses by a 
coarse and compressed cellular tissue. 
Fatty liver is generally consistent and solid 
in its texture, but sometimes the fat exists 
almost in a fluid state. Portal has observed 
the liver quite white and softened almost to the 
fluidity of melted fat, where no hepatic sym- 
ptoms existed during life; and he particularly 
records the case of a woman suffering under a 
severe form of syphilis in which this condition 
of the liver existed. 
From the name which has been given to this 
disease by pathologists, fatty degeneration, we 
might be led to infer that the texture of the 
organ was actually converted into this oily sub- 
stance. This, however, is quite inconsistent 
with our knowledge of pathological phenomena. 
The fatty deposition is obviously an undue 
ABNORMAL ANATOMY OF THE LIVER. 
secretion of a normal constituent, but wheth 
resulting from irritation from whatever causi 
or from absence of vital energy, is a quest 
upon which I am unwilling, without furtl 
investigation, to hazard an opinion. f 
regard to the causes of fatty liver Am 
observes, “ Les causes sous |’influer 
phe eae le foie devient le siége d’une 
e matiére grasse sont encore inconnues. ( 
émis qu’une hypothése lorsq’on a dit que 
dégénération graisseuse du foie était le pro 
d’une irritation de cet organe. Car on po 
tout aussi bien soutenir que cette dégénéra 
graisseuse, loin d’avoir été précédée par un 
dirritation du foie, est survenue parcequt 
nutrition de cet organe est devenue mo 
active; et cette derniére hypothése serait d% 
tant plus soutenable, qu’elle se déduirait d’ 
grande loi de l’économie en vertu de laqué 
toutes les fois qu’un organe tend a s’atro 
une matiére grasse vient & se sécréter autour’ 
cet organe ou ala place méme de ses mo 
cules.”’* 
Fatty liver is most frequently observed” 
persons who have died from scrofulous tuber 
in the lungs; in those, says Andral, in 
the blood has not been efficiently arterial 
and in whom the pulmonary exhalatic 
greatly diminished. Can it be, he inqui 
from the absence of the due separation 
hydrogen from the lungs that this compoune 
hydrogen, fat, becomes deposited in the pare 
chyma of the liver? ‘This question is wi 
deserving the attention of pathologists, 
solution might lead to important inform: 
The disease has also been observed in 
cancerous disorders and in dartrous dise 
of the skin. 
g- Pus. Abscess in the liver occurs in 
rincipal forms, either as a single abscess + 
arge size inclosed in a cyst, or as numero 
small collections of matter, bounded by 
substance of the liver or diffused amongst 
lobules. In the first form it constitutes idi 
pathic abscess of the liver, a disease of tropi 
countries, and rare in our tem te 
Abscess is generally preceded by acute inflai 
mation and more rarely by chronic inflam 
tion, and attains an enormous size, engrossi 
the whole of the right lobe and sometimes ¢¢ 
verting the entire organ into one huge cy; 
The cyst may be thin or thick, and more or! 
organised. Andral and Louis conceive th 
its internal surface is analogous to at 
membrane. The quantity of pus contained 
one of these abscesses varies from a few ow 
to several pints. My friend Dr, Macna 
who has seen much practice in the West 
during a residence of twenty-two y 
Jamaica, has observed that abscess in the liv 
occurs more rarely in the West than in the EB 
and, moreover, that this disease affects the Bur 
peans and not the Negroes. During the who 
of his experience he never saw a single case of 
abscess in the liver in the Negro, and among the © 
white population of his district only four well 
aienanaial 
* Anatomie Pathologique, vol. ii. p. 597 
