INTERSTITIAL CHRONIC HEPATITIS. 



287 



it creaks under the sharp knife. When cirrhosis is old, the surface 

 of the liver is granulated and irregular, sometimes covered with 

 new membranes ; the serous membrane is thickened, whitish, and 

 opaque. At the beginning the color of the liver is nutmeg-brown; 

 later it turns light yellow, and the organ becomes anemic. On 

 section we find a fibrinous network formed by the connective hyper- 

 plasia, a network the principal traces of which circumscribe more 

 or less large fields of the atrophied hepatic parenchyma, whilst its 

 ramifications separate the various hepatic lobules. From a histo- 

 logical point of view we observe, at the beginning of the process, 

 a cellular infiltration in the connective tissue of the portal spaces ; 

 later the proliferation of the intra- and extra-lobular connective 

 tissue commences.^ With these alterations of the liver we find 

 also a passive hyperemia and a chronic catarrh of the stomach and 

 intestine, ascites, anasarca, congestion of the meninges, and hemor- 

 rhages in different organs. In Schweinsberg disease there exists a 

 manifest gastric dilatation. 



Symptoms. They appear very slowly. In most cases the 

 disease starts insensibly with digestive troubles ; constipation 

 alternates with diarrhea, and emaciation becomes gradually appar- 

 ent. To these symptoms are added a slight icterus, the sensitive 

 condition of the region of the liver to palpation, and, in the dog, 

 ascites and anasarca. In the horse we observe, in .addition, a special 

 sensitiveness, weakness, periodic colics, and symptoms of immo- 

 bility. The causes of cerebral troubles are obscure ; they may be 

 attributed either to the retention of biliary matters in the blood 

 (acholia) or to a complication of chronic pachymeningitis. At the 

 start the trouble is apyretic ; later, a febrile reaction sets in which 

 is more or less marked (39° to 39.5° C). Its duration varies from 

 a few months to several years. 



Treatment. The treatment of chronic hepatitis is purely pallia- 

 tive. It is based on the use of alkalines (Carlsbad salts) and diu- 



1 In our domestic animals, but mainly in the dog, we may recognize three different 

 varieties of cirrhosis found in man : 1. Atrophic cirrhosis (Laennec) — annular, multi- 

 lobular, and extra-lobular, of venous origin, which starts with a phlebitis of the small 

 portal vessels, and in which the liver is atrophied, deformed, granular, and the 

 hepatic cells altered or destroyed. 2. Hypertrophic cirrhosis (Hanot) — insular, mono- 

 lobular, extra- and intra- lobular, which starts with an angeiocholitis of the small 

 biliary canals, and in which the liver is very voluminous and the hepatic cells are 

 either intact or hypertrophied. 3. Mixed or intermediary cirrhosis (Dieulafoy), in 

 which we find added some elementary lesions belonging to atrophic and hypertrophic 

 cirrhosis. — n. d. t. 



