Lebert contests the presence of pus. The tissue has a particularly yellow color, it is resistant and elastic. At the middle of the mesh, formed by the pulmonary network of fibro-plastic elements, is found a soft sub stance, pulpy, diffused, and in which are many little cells, which are neither cancerous, nor tuberculous elements, but resemble in every way the cells of syphilitic gummata.
Liven—There is described, sometimes simple hypertrophy, sometimes general or partial congestion. Gubler has described the organic lesion which is peculiar to the liver. This lesion may be general or partial.
1st. General.—When the alteration is of high degree, the gland shows a yellow color, very different from the normal condition, and which is best compared to the hue of flint. The appearance of the two substances has completely vanished, only on the yellow base we find, on close atten tion, a more or less clear space of little white opaque grains, looking like grains of millet, and free arborizations appertaining to the exsanguin ated vessels. The liver is sensibly hypertrophied, globular, tinged, hard and difficult to grasp with the fingers; it tears without allowing an im pression on the surface. Its elasticity is such that if pressed forcibly be tween the fingers, so as to crush a wedge-shaped piece from its sharp edge, the piece escapes like a cherry-stone from the compressing fingers. In cised it creaks under the scalpel. The incisions which are made into the liver should be very clean, homogeneous, and the great consistence allows us to obtain very thin sections, semi-transparent, which to a certain de gree are found in the naturally thinned portions of the organ (as the bor ders and especially in the tongue which terminates the left lobe.) 2d. Parlial.—This form is more common than the general. The liver is less enlarged and shows an undecided coloring, shaded yellow and red dish-brown. No part of the parenchyma appears entirely sound. At the same time the liver has a certain semi-transparency, which allows one to distinguish, at a little depth, millet-like, the grains with which its sub stance appears strewn. These opaque points are here more numerous and compact. In fact these opaque grains, plunged lightly into the transpar ent substance, reproduce to a certain point the aspect of the two sub stances which constitute the hepatic tissue, but, beyond that, the grains are separated by very great intervals, the surface aubstance does not re semble particularly the net-work, essentially vascular, of the areolar spaces of the healthy state.
Under the microscope we find, in the altered tissue, a considerable, sometimes enormous, quantity of fibro-plastic elements in all stages of evolution, in the centre of which the ecchymosed cells are dispersed. The relation of these fibro-plastic elements, by their connection with the proper tissue of the organ, is more or less strong as the alteration is more or less advanced. There is very little in the parts, still brownish, of the second form, or it is lost in the midst of the proper cells. They are, on the contrary, very predominant in the yellow and very hard livers, as well as in the strongly indurated portions of the livers which only present a partial alteration, while they exist very slightly in parts whose aspect is only slightly modified, and not at all in normally appearing tissue. The fusiform bodies strike us at first; of which some are short, shaped like a spindle, the others very long, enlarged in the centre, and terminating by tapering extremities. Nearly all have an oval or ellipsoid nucleus enclos ing a granular substance, in the midst of which are noticed one, two, or three larger granules, of a more fiery brilliancy. There are also many rounded or oval cells, sufficiently like the smaller cells of the parenchyma, but enclosing nuclei, like the fibres. In some cases, especially in the general form, there is found in the tissue indurated nuclei, of which some are soft and filled with a purulent material, true suppurating gummata. Under pressure the liver yields a yellowish liquid, a little ropy, partly coagulable by heat. The heart is soft and flabby, containing a Currant jelly like liquid, characterized by a notable diminution of the globules, which are dissolved in albumin. The pericardium and the cardiac mus cular tissue are filled with milky patches.