This deposition of fibrous tissue produces different effects according to the parts it prin cipally involves. Sometimes the lymph is ef fused exclusively into the cellular tissue of the portal canals of considerable size, and if the person die some time after this has occurred, all the considerable branches of the portal vein are found surrounded, in some places, to the distance of half an inch, by new fibrous tissue, which by its contraction has drawn in and puckered the adjacent portions of the liver. The remaining portions of the liver may be little or not at all altered in texture, and may be readily scraped away from these indurated portions ; the tnain branches of the portal vein are still perviousolout many of the small branches leading from them are obliter ated, the parts which they supply atrophied, and the liver correspondingly diminished in bulk. When such portions are near the sur face, the capsule is drawn in, thickened and puckered, and generally covered with false membranes.
In other cases, the fibrous tissue is not found around the larger veins, but in the vi cinity of the small twigs that separate the lobules ; all the substance of the liver is thus rendered tough ; and when the organ is sliced, the fibrous tissue is seen to form distinct lines, between small irregular masses of lobules. At the parts on the surface of the liver which correspond to these lines, the capsule is drawn in, so that the organ presents what is termed a hobnailed appearance.. The degree of hard ness is determined by the amount of the adven titious tissue, and, as a general rule, the denser the organ, the paler its colour ; ordinarily, the colour is pale grey, or resembles that of impure wax; and hence the term Cirrhosis.
Induration of the liver occurs around growths, abscesses, and hydatid cysts, and may be produced by inflammatory action of a specific or non-specific nature.
Softening of the spleen is produced by an altered state of the fluid which it contains naturally, and by inflammatory action, or by both causes. Softening produced by the first means is common in low fever, intermittents, and scurvy the fibrous element of the spleen does not st:ffer ; but the blood, which is con tained within its nteshes, loses its natural con sistence, appears to lose its coagulating power, becomes dark, and is washed away, leaving the white fibres intact, by a slight stream of water. In softening from inflammatory action the whole tissue of the spleen is dis organized ; it breaks down under the slight est pressure ; the external fibrous envelope is much softer than usual ; and its internal prolongation is totally destroyed. Both of these kinds of softening occur, with or with out alteration, in the bulk and dimensions of the organ.
Induration of the spleen may also arise from an abnormal state of the blood, and from in flammatory action. When the consistence of the blood is altered, the spleen, which may or may not be enlarged, cuts like liver or frozen muscle ; and no great quantity of blood follows the incision, the whole tissue being, in fact, denser than usual.
Inflammatory hardening may or may not be equal in degree throughout the whole organ ; frequently, certain spots, the seat of old effu sions of blood, are denser than the indurated tissue around them ; and eccymoses and dark yellow and black spots, are found sometimes scattered over the hardened tissue. This variety of induration may be accompanied by increase or decrease of bulk, or no alteration in size may occur ; in degree, it may vary from the slightest increase of consistence, de pending upon excessive nutrition, to a bony hardness.
Softening of Hie kidney is of common occur rence, being frequently found, with an enlarged state of the organ, in several of the diseases comprehended under the term Bright's disease. It exists also in the kidneys of diabetic sub jects, and in some cases of renal calculi. When produced by inflammatory action, the softened kidney is dark red, and when a con sequence of a perverted state of the nutrition of the organ, it is usually of a pale colour. Ge nerally speaking, the softened state is produced by enlargement of the uriniferous tubes, and a consequent diminution of the solid matrix, or this last only may be affected ; and when such is the case, the tissue breaks down with the slightest pressure. In degree, softening may vary from simple flabbiness to a state ap proaching diffluence.
Induration of the kidney is generally found with an atrophied state of the organ ; it is a sequel of acute, and is found in chronic, ne phritis, especially in gouty subjects. In these the kidney is frequently indurated, paler than natural, less vascular, and many of its tubes may be blocked up tvith urate of soda. In duration is sometimes accompanied by an hypertrophied and a darkened state of the organ. In the first stage of induration, the consistence of the organ is slightly exagge rated, and the finger rnakes no impression on it ; in such kidneys we find superficial star like venous twigs, and more or less confusion of the cortical tissue. In a more advanced stage, the tissue may become nearly as hard as cartilage, and perfectly colourless. Por tions only of the kidney may be affected, but, generally, the greater part of it suffers ; and it is, comparatively speaking, rare to find car tilaginous induration of one or more of the mammilated processes.