Fig. 121.—Appearance of the liver in necrosing hepatitis
Causation. According to Stubbe, these lesions are produced by microbes, originating in the intestines, and carried to the liver by the mesenteric veins. The lesions and blood of the liver yield cultures of a microbe resembling that of necrosis; nevertheless, such lesions have not been experimentally reproduced.
According to Berndt, infection from the uterus is possible, and indeed probable. Moussu has only seen three cases of this particular condition of the liver in living animals. Two of these were in a working ox and a bull respectively, so that Berndt’s view would not seem to be exclusively applicable. Moussu is convinced that infection is of intestinal origin, and that it takes place through the mesenteric veins; he claims to have found the proof of this in the existence of multiple pylephlebitis and complete obliteration of the subhepatic veins in some cases.
Symptoms. The symptoms are so vague as to render diagnosis difficult. Berndt, on the other hand, regards it as fairly easy. He states that the disease occurs in old cows, which after parturition show loss of appetite, polydipsia, fever, dyspnœa, and short, feeble cough, suggesting pneumonia. After a few days the animals appear extremely weak, remain lying for long periods, and exhibit icterus. Percussion of the liver detects abnormal sensibility and hypertrophy.
The three cases seen by Moussu showed only slight yellowness of the membranes, general weakness and difficulty in walking, which at first glance appeared to suggest laminitis, marked hypertrophy of the liver, sensitiveness over the hepatic region, and, as complications, uncontrollable diarrhœa and peritonitis. But these symptoms are also noted in suppurating echinococcosis, and even in cancer of the biliary ducts, so that diagnosis does not appear easy. Nevertheless, there is always marked fever, and on post-mortem examination it is not unusual to find, in addition to the hepatic lesions, a certain amount of perihepatitis, partial peritonitis, and even pleurisy in the region of the diaphragm. The question is of little practical importance, for the gravity of the disease just described is such that economically no treatment is possible. The great point lies in correctly diagnosing disease of the liver, and that is relatively easy.
CANCER OF THE LIVER AND BILE DUCTS.
Cancer of the liver, that is, broadly speaking, the development in the liver of malignant tumours, capable of becoming generalised throughout the organism, is comparatively rare when compared with parasitic diseases of the same organ. It may be primary or secondary in character, but is much more frequently secondary. In bovines primary cancer assumes the forms of adenomata, trabecular epitheliomata, or adeno-carcinomata. Moussu describes a case in which the growths assumed the form of papillomata or adeno-papillomata extending throughout the biliary ducts, and partly obstructing the common bile duct, which was greatly dilated.
The real cause of these, as of all other primary tumours, remains shrouded in mystery.
Secondary cancer is more frequent; it occurs usually in the form of little isolated tumours (nodular cancer) of varying size and greyish colour.
Symptoms. Clinically the description, or rather the identification, of cancers of the liver is difficult, and the diagnosis particularly troublesome in cases of primary cancer.