Cirrhosis of the liver and icterus of four years' duration : with remarks on biliary cirrhosis / by F. Parkes Weber.

  • Frederick Parkes Weber
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Cirrhosis of the liver and icterus of four years' duration : with remarks on biliary cirrhosis / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    measure could, of course, only be palliative,* *® but when due to calculi in the common bile duct, the cirrhotic process in the liver might be prevented or delayed, and the calculi tliemselves nnght perhaps be removed later on. I will only add^ in conclusion, that if one leaves out of the question cirrhosis from syphilitic scarring and some (etiolo- gically doubtful) forms of cirrhosis, such as the rare “ pig- mentary cirrhosis with diabetes ” first described by Hanot and Chauffard in 1882, the types of cirrhosis may, I believe, be grouped as follows: 1. The ordinary form, usually due to alcohol, in which the cirrhotic process probably commences around the branches of the portal vein. The liver may be either enlarged or diminished in this form of cirrhosis. 2. The hypertrophic and biliary forms of Hanot and Char- cot associated with chronic jaundice, in which the cirrhotic process probably commences around the minute bile ducts. 3. A kind of cirrhosis met with in cases of splenic anaemia*® in which the cirrhosis of the liver appears to follow chronic enlargement of the spleen. Possibly in these rare cases the cirrhotic process commences about the lymphatic radicals in the liver; at least part of the process would then correspond to Charcot’s unicellular or pericellular form of cirrhosis. Tn many cases of congenital syphilitic disease of the liver in infants the distribution of the cirrhotic process is chiefiy intercellular. The present ease affords, I believe, an illustration of the fact that in distinguishing post-mortem specimens of biliary cirrhosis, and Hanot’s type of hypertrophic cirrhosis, from cases of ordinary cirrhosis, the main history of the case during life is of as great importance as the special anatomico- pathological features presented by the liver after death. The paper will, however, I hope, be found to contain some matter of interest in other directions than this. CJ. Dr. H. D. RoUeston’s remarks on this subject in his paper on Primary Carcinoma of the larger Bile Ducts, Medical Chronicle, January, 18^. *9 Dr. Banti, of Florence, was, 1 believe, first to describe it. Dr. Douglas Stanley and others have directed attention to it in England.
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