194 
Sometimes these tumours present a certain de- 
gree of consistence, but as they increase in 
size they become more and more softened and 
M Baillie describes a large tumour in 
the liver which he considers scrofulous from 
being softened in the centre, and containing a 
fluid resembling pus; this is most probably 
a tumour of the kind I am now describing. 
Another tumour, of which he expresses himself 
at a loss to understand the nature, soft, of a 
brownish colour, and of about the size of a 
nut, appears to be also referable to the same 
es. 
The second and third varieties of the tubera 
diffusa of Farre present characters resembling this 
disease. V. 2. “ Tubera, elevated at the surfaces 
of the affected organ, encysted, or having dis- 
tinct cells, formed by the growth of a fungus, 
which separates in flakes, and is composed of 
a fine reticular texture, containing an opaque 
white fluid.” V. 3. “ Tumours rising with a 
regular swell from the surfaces of the affected 
parts and yielding to the touch, composed of a 
very delicate reticular texture, pulpy in its 
consistence, varying in its colour even in the 
same subject, charged with an opaque fluid, 
and growing from cysts or cells.” 
Cruveilhier considers the venous capillary 
stem as the seat of origin of carcinoma, par- 
ticularly of the form which I am now consi- 
dering ; hence he observes, “ Ayant exprimé 
d’une coupe faite 4 un foie cancéreux une ma- 
titre d’un blanc-rougeatre, encéphaloide qui 
se moulait 4 la maniére du vermicelle, et qui 
pouvait acquérir en se tordant une grande lon- 
gueur, j’apercus sur cette coupe un orifice plus 
considérable que les autres ; j'incisai cet orifice 
et je parvins dans un vaisseau tres volumineux 
qui me parut étre une des ramifications de la 
veine porte. Alors je disséquai avec beaucoup 
d’attention cette veine, et je ne fus pas peu 
€tonné de voir que cette veine, depuis les plus 
grandes jusq’aux plus petites divisions, était 
remplie par cette matiere encéphaloide, adhé- 
rente aux parois et tout-a-fait semblable a celle 
or exprimait par les coupes faites au foie. 
1 me fut facile de suivre les ramifications ex- 
tremement dilatées de la veine jusque dans 
l’areoles des coupes. L/altération était bornée 
a la veine porte, les veines hépatiques et leurs 
ramifications étaient parfaitement saines.’’* 
l. Fungus hematodes is the term applied to 
all carcinomatous tumours which have a ten- 
dency to the unnatural development of new 
vessels and to effusions of blood into their tissue. 
In the same organ, hard and cartilaginous 
scirrhous tumours may exist with those of a 
softer texture, and of a medullary form, and 
both of these may be mingled together in the 
soft, elastic, and bleeding mass which consti- 
tutes fungus hematodes. The tumours of 
fungus hematodes are often of very large size, 
and by their frequent hemorrhagies give rise to 
extreme eee and the speedy death of the 
patient. Farre arranges this form of carcinoma 
among his tubera diffusa, of which it forms the 
fourth variety, which he thus defines: “ Tu- 
* Anatomie Pathologique, liv. 12. 
“ABNORMAL ANATOMY OF THE LIVER. 
mours elevated at the surfaces of the liver and 
inclining to a round figure ; pulpy in their con- 
sistence, being charged with a thick and opaque 
fluid, variegated in their colour, chiefly hite 
mingled with red, the former prevailing in thei 
incipient, the latter in their advanced stage 
composed of a very vascular and reticular te 
ture, attached either to distinct pouches or 
the substance of the liver, and so unlim 
and rapid in its growth as to burst or destn 
the peritoneal tunic of this organ and to 
trude in the form of a bleeding fungus.” 
_m. Melanosis.—Melanosis exists in the li 
as in other structures of the body, 1st, as 
melanic secretion infiltrating the cellular str 
ture of the organ, and giving a diffused gene 
blackness to the substance of the lobules; 2 
as a morbid tissue com of an areolar: 
lular network, in which the black carbonace¢ 
matter is deposited; or 3dly, as a mela 
pigment accompanying carcinoma or tuber 
and imbuing the abnormal tissue with its’ 
culiar colour. The colour of melanosis in t 
liver varies from a deep chocolate-brown t 
rich black. Sometimes it is diffused in patel 
through the substance of the organ, at oth 
times it exists in the form of rounded cireut 
scribed tubercles of variable size and numb 
Laennec considers melanosis as an 
tissue without analogue among the animal t 
sues ; he classes it with cancerous deger 
tions, and describes it as existing in his tt 
favourite conditions of crudity and soften 
But the researches of Cruveilhier have shey 
that in many instances melanosis is to be t 
ceived as a mere pigment, resembling the p 
mentum nigrum of the choroid, which impress 
its peculiar colour upon natural and mor 
tissues, and he has also proved, in oppositi 
to the view entertained by Laennec, that 1 
softened state or state of infiltration 
que? recedes the more dense and en 
orm. Melanosis rarely exists in the liver 
out being at the same time found in vario 
other structures of the body, as in the brat 
eye, lungs, heart, spleen, kidney, mucous m 
brane, muscles, skin, &e. 
6. DisorpERs or FruNcTION.—The princi 
function of the liver being the secretion of b 
we shall have to consider under this head ¢ 
changes which may occur in the secretion” 
this fluid and in the fluid itself, in consequei 
of derangement of function in the organ. The 
disorders may be divided into three kinds: 
a. Suppression of the bile. " 
b. Alterations in the physical properties 
the bile. ‘ 
c. Alterations in the chemical qualities” 
the bile. ; 
a. Suppression of secretion of the bile, 
suppression of urine, occasionally occurs — 
the liver. This disease appears to have be 
known to Darwin,* who calls it “ ps 
the secretory vessels” of the liver; the patients, 
he says, “ lose their appetite, then their fles 
and strength diminish in consequence, the 
appears no bile in their stools nor in their urine 
. 
Aaccide 
ull 
* Zoonomia, vol. ii, p. 5, 
