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Cirrhosis

tissue, liver, kidney and connective

CIRRHO'SIS (Neo-Lat.. front Gk. KLI3A6s, kirrhos, tawny). A pathological change of tis sues, consisting of hardening due to increase of connective tissue. It may occur in lung, spleen, ovary, heart. stomach, and peritoneum, but is oftener found in kidney or liver. Cirrhosis of the kidney (chronic diffuse inflammation of the kidney, or chronic interstitial nephritis) is a chronic inflammation of the connective-tissue dements of the kidney. The kidney is usually small, contracted, and nodular, the capsule ad herent; the cortex is thin and red, and may con tain small cysts. Microscopically-, there is seen to be a marked increase in the interstitial con nective tissue, with degeneration and atrophy of the funetionating elements, the renal tubules, and the glomeruli. In the tubules the epithelium is apt to be granular, fatty, and atrophied. In the glomeruli the lesions vary from thickening of the capsules and of the capillary walls with hyaline degeneration, to complete atrophy and disappearance of the glomeruli. (See I:RIGHT'S DISE?. SE. ) Cirrhosis of the liter, or chronic interstitial hepatitis. consists in a greater or less increase in the connective tissue or supportive elements of the liver, at the expense of the lune tionating tissue. The new connect ive tissue usu ally follows the line of the old connective tissue, but may penetrate the lobules. it is often ir regular in its distribution. being more abundant

in one part of the liver than in another. Dur ing the early stages of the produetion of con nective tissue, the liver tends to enlarge. some times weighim.c, eight to ten pounds (hypert rophic cirrhosis). Later, the connective tissue tends to contract. and the liver becomes smaller than normal (atrophic. cirrhosis). The surfaces of the large livers are usually smooth, while the irregular contraction of the connective tissue in the atrophic livers squeezes the lobules, and usually results in nodular surfaces. The new connective• tissue, besides causing atrophy of the liver-cells, often compresses branches of the por tal or hepatic veins and of the gall-ducts, thus interfering with the nutrition of the liver-cells, and causing stoppage of the bile-current. De pendent upon the condition in the liver and the consequent disturbance of the portal circula tion, various secondary lesions occur, such as dilatation of the veins, accumulation of fluid in the abdomen, swelling of the feet and legs, etc. increase in the connective-tissue elements of the kidney (cirrhosis of the kidney) and of the walls of the blood-vessels is frequently associated with cirrhosis of the liver, probably dependent, upon the some obscure cause. See LIVER; ALCOHOL ISM; DROPSY.