150 
what cubical epithelial cells, but these are nothing like so numerous 
as in hypertrophic cirrhosis of the liver, being, indeed, scarcely more 
evident than in the atrophic form. 
Fig. 2 of Plate I shows a portion of a liver lobule under a higher 
magnification (Zeiss A. Oc. 2), and includes some of a periportal 
fibrous band. The very great increase of the intercellular connective 
tissue of the lobule will be at once apparent, the epithelial cells 
forming barely half of the area of the lobule, each column of liver 
cells being separated from the next by an extensive layer of fibro- 
cellular connective tissue. In places the liver cells contained much 
yellow pigment derived from broken down red cells anaemia being 
a marked symptom of the later stages of kala-azar. although fre¬ 
quently only slight in degree in the first few months of the disease, 
much less so than in true malarial fever of any duration. With this 
exception the surviving liver cells have a fairly healthy appearance, 
and stain well. The connective tissue between the liver cells is 
partly fibrous, but chiefly consists of small round cells together with 
a considerable number of larger epitheloid-like ones, some of consi- 
erable size. It is the latter which were found to still contain the 
parasites of kala-azar in specially stained sections, and they are 
doubtless the enlarged endothelial cells of the capillary vessels, 
, f 4.T, I described as containing the human 
stage of the kala-azar parasite. 
neri 1' of the organism at once furnishes the key to the 
LnutT connective tissue proliferation. These 
ThTir cells, and on reaching 
he b i s! ‘he parasites into 
Lbers in T ■" comparLvely small 
big h k y‘« more particularly. These 
the cycle is repeated’” When this 
years as in ^ • e process continues for a number of 
the liver superve^’^^k k T ^ cirrhosis of 
irritation of the parasite rp that eventually the constant 
around the capillarv Proliferation of the connective tissue 
less exten: m G^^:at ^ 
produces the condition above descTbed'’ '’ti.'’”'*"' ” 
round the capilUu-y vessels of tV >m>versal thickening 
of the liver causes both an extensive 
