nnective tissue is very apt to increase at the expense
of the cellular elements, destroying their functions. This cirrhotic
process usually follows long-continued irritation, such as is produced
by too much alcohol absorbed from the bowel habitually, the organ
gradually becoming harder in texture and smaller in bulk. Hypertrophic
cirrhosis of the liver is not uncommonly met with, in which the liver is
much increased in size, the "unilobular" form, also of alcoholic origin.
In still-born children and in some infants a form of hypertrophic
cirrhosis is occasionally seen, probably of hereditary syphilitic
origin. Acute congestion of the liver forms an important symptom of
malarial fever, and often leads in time to establishment of cirrhotic
changes; here the liver is generally enlarged, but not invariably so,
and the part played by alcohol in its causation has still to be
investigated. Acute yellow atrophy of the liver is a disease _sui
generis_. Of rare occurrence, possibly of toxic origin, it is marked by
jaundice, at first of usual type, later becoming most intense; by
vomiting; haemorrhages widely distributed; rapid diminution in the size
of the liver; the appearance of leucin and tyrosin in the urine, with
lessened urea; and in two or three days, death. The liver after death is
soft, of a reddish colour dotted with yellow patches, and weighs only
about a third part of the normal--about 11/2 lb in place of 3-3/4 lb. A
closely analogous affection of the liver, known as Weil's disease, is of
infectious type, and has been noted in epidemic form. In this the
spleen and liver are commonly but not always swollen, and the liver is
often tender on pressure. As a large proportion of the sufferers from
this disease have been butchers, and the epidemics have occurred in the
hot season of the year, it probably arises from contact with decomposing
animal matter. Hepatic abscess may follow on an attack of amoebic
dysentery, and is produced either by infection through the portal vein,
or by direct infection from the adjacent colon. In general pyaemia
multiple small abscesses may occur in the liver.

_The Gall-Bladder._--The formation of biliary calculi in the
gall-bladder is the chief point of interest here. At least 75% of such
cases occur in women, especially in those who have borne children.
Tight-lacing has been stated to act as an exciting cause, owing to the
consequent retardation of the flow of bile. Gall-stones may number from