DISEASES OF THE LYMPHATIC TISSUES 131 
into Portal, Biliary, Fatty, Perilobular and Vascular. 
By a study of the spleens in these cases a few facts have 
been obtained. In mammalian portal cirrhoses there is 
usually a very moderate but definite increase in the size 
of the spleen due to connective tissue increase in the 
trabeculae and reticulum, with very small compact fol- 
licles. Among the birds the organ seldom shows more 
that a moderate congestion and diffuse hyperplasia. In 
the mammalian biliary cirrhoses there is almost without 
exception a definite enlargement due to fibrosis and fol- 
licular hyperplasia. Among the birds the process is very 
far from uniform, there being just as often no change, as 
a congestion and hyperplasia, or as a mild fibrosis ; it is 
notable, however, that pigmentation is commonly met in 
this class. No noteworthy change is met with in the 
spleen of fatty hepatic cirrhoses. We have no record 
of cyanotic induration of the spleen accompanying a 
similar condition in the liver. When the condition of 
perilobular hepatic fibrosis has been met a distinct 
increase of the splenic pigment is usually found. In 
reviewing the facts in this paragraph one is forced to the 
conclusion that, with the exception of the frank infective 
cases, there is no definite relation of the splenic changes 
to those in hepatic cirrhosis, a fact made perhaps the 
more significant in view of the idea held in some quarters 
that the primary change in this pathological process 
occurs in the spleen. 
Perisplenitis. 
Perisplenitis of an acute or fibrosing variety as a part 
of peritonitis or as the result of an injury to the splenic 
region, has been encountered on numerous occasions and 
offers nothing worthy of comment, but the so-called 
'^ sugar-icing " spleen, associated with perihepatitis and 
general peritoneal thickening, and with an obscure rela- 
tion to tuberculosis has not been seen. As we shall learn 
later peritoneal or massive intestinal tuberculosis is not 
