Abscess of the liver arises from the introduc tion into it of some septic agent through the circulation or through the bile-duets, and mar be multiple or single. The single or solitary abscess is common in tropical countries, often follows an attack of dysentery, and is thought to he caused by the Anorba coli. Solitary abscesses often reach an enormous size, and the pus may make its way into the peritoneal cavity, or into the pleural cavity, where it may perforate the lung and be discharged by coughing; or it point through the skin. These abscesses are best treated by evacuating the pus by surgical means. Multiple abscesses are usually a result ot pyfenlia, (q.v.) and are very fatal.
Cirrhosis (KL/3/30s, yellow), or chronic inter stitial hepatitis, is a slow inflammation of the liver which results in an extensive growth, usually in the course of the portal canals, of a fibrous contractile tissue which compresses and destroys the secreting cells and seriously ob structs the circulation of the blood through the portal system of veins. The disease may assume two forms: hypertrophic cirrhosis, in which the organ is greatly enlarged and its surface smooth; and atrophic cirrhosis, in which the gland is re duced often to less than half its normal size. and the surface is rough or nodular ('110)11:61 liver') from the irregular contraction of bonds of fibrous tissue. In the great majority of cases cirrhosis is caused by the excessive use of alcohol in the form of beer, wine. or spirits. The symptom-3 are characteristic, especially in advanced eases.
Obstructive circulatory disturiainees are mani fested in the stomach by nausea and vomiting. sometimes of blood; in the lower intestinal tract hy hemorrhoids, and in the abdominal cavity by aseites. In this form of dropsy the ef fused fluid may amount to three or four lons. Jaundice is a symptom more apt to occur in the hypertrophic than in the atrophic variety of cirrhosis. The disease is very intractable, but
some patients live for years in comparative com fort with proper treatment. The taking of alcohol must be stopped entirely; the diet must be light but nutritious; and the bowels kept active. When ascites supervenes, attempts are made to promote its absorption by giving dinretw and purgative drugs; but it is often necessary to draw the tluid off repeatedly by puncturing the abdominal wall.
Fatty firer may be the result of an excessive deposit of fat cells in the organ, in eases of gel oral obesity. or in emaciating diseases such as phthisis, or it may be a true degeneration in which the tissue elements are replaced by fat. The latter change takes place in acute atrophy (see above), and notably in phosphorus poisoning. The I ilVer is enlarged. smooth, its edges are rounded, and it is yellowish-white on section.
Amyloid or waxy firer occurs in association with in other orga T1S —the brain, spleen, stomach, kidneys, and intestines. It is attributed to long-standing from phtsisis. syphilis. tubercular disease of the bones or joints, and to empyema. Treatment depends upon removing the cause of suppuration. See WAXY DEGENERATION.
The liver may be the seat of tuberculosis, can cer, and syphilis. Tuberculosis occurs only as a part of a general infection. (See section on the Liver.) In cancer the gland becomes enlarged, hard. and nodular and irregu lar in outline. The disease is hopeless and treat ment only palliative. Syphilis of the liver may be hereditary or acquired. In the first form it occurs as an interstitial hepatitis, in the second as a giumnatous deposit during the third stage of the disease. See SYPHILIS.
Ilydatid cysts are found in the liver more often than anywhere else in the body. These are caused by a minute intestinal tapeworm— Ts eechinococcus.
See also CALCULUS; BILE; JAUNDICE; and CIRRHOSIS.