12 ARTIFICIAL PRODUCTION OF TUBERCLE. 



density and loss of elasticity of the lung wliich occurs in the early stages of 

 tuberculosis, and which cannot be satisfactorily accounted for by the mere 

 presence of the grey granulations (Plate II. fig. 4). 



The bronchial glands are affected exactly like the axillary, and a 

 description of the one applies precisely to the other, except that the cheesy 

 changes are rather less marked, and spots of softening are less common in 

 the bronchial glands. 



The next organ which presents marked changes is the liver (Plate I. 

 fig. 4). It is greatly increased in size, and is heavier than natural. In it are 

 seen two or three sets of changes, which, however, I think, all belong to one 

 type. The chief of these is the appearance of a tissue of a glistening semi- 

 transparent character, which occupies the substance of the organ to a variable 

 extent. Sometimes it only occurs in little specks, of the size of a pin's head or 

 a poppy-seed ; sometimes it is in larger masses ; sometimes it runs in lines, 

 mapping out the acini very distinctly ; sometimes it is found in irregular 

 masses in which there is no trace of liver-structure visible to the naked eye ; 

 or the conditions before described may be reversed, and remains of natural- 

 looking liver-tissue may be seen running in lines irregularly through the 

 semi-transparent tissue. 



In the first of these cases, the disease might almost suggest the idea of 

 cirrhosis ; in the second, that of an albuminoid liver ; but even to the naked 

 eye it differs from the cirrhosed liver in being crisp and friable and destitute of 

 all toughness, and from both it and the albuminoid liver in the fracture being 

 finely granular. This tissue never stains with iodine ; and it almost invariably 

 has an appearance which shows, more or less distinctly, that it was originally 

 composed of fine granulations. Moreover, under the microscope the change is 

 seen to be of a kind absolutely different from that which occurs in the larda- 

 ceous liver, inasmuch as here there is no sign of the waxy change in the 

 secreting cells which characterises the lardaceous disease. In other cases, the 

 granulations are not confluent, but are scattered thickly through the liver- 

 tissue. They do not project notably from the surface, and the peritoneum is 

 not, as a rule, thickened. 



In some places, there are seen, irregularly scattered in the liver-tissue, 

 spots of a dead opaque white, sometimes surrounded by a zone of injection. 

 Their section is finely granular, not smooth like those next to be described, 

 and they appear to result from a fatty degeneration of the acini. 



There are also seen, both in the larger tracts of semi-transparent tissue, 

 and also when this change only occurs in the form of granulations, spots of 

 cheesy change. These may be either seen occupying the area only of indi- 



