CIRRONOSIS. (Kcgoc, lavas ; vocros) morbus.) In a memoir publislied by M. Lob stein in the first volume of the Repertoire d'ilnatontie and de Physiologie for the year 1826, this term was applied to what that author considers to be a disease affecting the fcetus at an early period of intra-uterine life. The essential characteristic of the malady consists in the serous or transparent membranes being dyed of a beautiful deep golden yellow colour. " The disease is," says M. Lobstein,_ 44 an internal jaundice of the peritoneum, of the pleura, of the pericardium, of the arachnoid, differing from the ordinary jaundice, in that it do.es not affect the parenchymatous cellular tissue of organs, nor the subcutaneous tissue, nor the skin, the usual seats of that disease." Lobstein published the first account of the occurrence of these appearances in two five month fcetuses, in his Rapports sur les travaux executes a l'Amphitheatie d'Anatomie de Strasbourg.t Since that time additional cases were presented to his attention, from which he ascertained that the yellow staining was not confined to the serous membranes only, but also was found in the nervous tissues, espe cially those of the spinal marrow and encepha lon'. By the aid of the microscope he perceived tliat the substance of the marroW seemed to be composed, as it were, of small grains of a lemon yellow colour, mixed with a white and pulpy substance, as if a very fine gold-coloured powder had been intimately mixed with a soft and semi-transparent jelly. In these cases the thoracic portion of the sympathetic also exhi bited a similar colour, and the ganglia were somewhat swollen, and it was ascertained by the microscope that the stain was equally inherent in the nervous substance of the ganglia as in that of the spinal marrow.
It is impossible to remove the yellow stain from the structures in this condition either by ablution or immersion for any length of time in alcohol or water. The intensity of the colour was not diminished in preparations which had been preserved in spirits for seven teen years, neither was it affected by the action of light.
The difficulty of accounting for the pheno mena which constitute this disease of the embryo is much increased by the fact that cirronosis has hitherto been observed only in three or five month fcetuses. As at this period the biliary secretion has not begun to be formed in the usual way, we cannot attribute the occurrence of this disease to any of the causes which give rise to ordinary jaundice, so com monly met with in the fcetus at and shortly after birth. There seems, however, to be no reason to doubt that the elementary constituents of the biliary secretion may already exist in the blood at an early period of intra-uterine life, and that from them the stain may have been communicated to the serous membranes and nervous tissues. But we cannot but express our concurrence in the opinion of Andra!, that cirronosis differs only in situa tion from the ordinary icterus infantum or neonatorum; there being this remarkable dis tinction also, that the tissues which are the seat of the colour in cirronosis are rarely affected in jaundice.
Although the observations of Lobstein were first published ten years ago, I do not find that they have been confirmed by any subse quent observer. The preceding account, there fore, of this disease rests entirely upon his authority, and is drawn up chiefly from his paper in the Repertoire already referred to.
(R. 13. Todd.)