=Granular Degeneration.= A peculiar change in the liver substance is sometimes found after death from various acute or infectious diseases, as the exanthemata, pyæmia, septicæmia, erysipelas, typhus, typhoid, and yellow fever, etc.; or from thrombosis of the portal vein, abscesses or cirrhosis, as well as in poisoning by arsenic, phosphorus or antimony. The change in the early stage consists in an accumulation in the liver cells, of a fine granular substance, soluble in alkalies, and apparently of an albuminous nature; and, at a later stage, of coarser shining particles of a fatty character, and soluble in æther or alcohol. =Atrophy= of the liver may be divided into the following forms: I. Simple Atrophy. II. Acute or Yellow Atrophy. III. Chronic Atrophy, or Cirrhosis. =Simple Atrophy.= By this, we understand a diminution in the size of the liver, without any alteration in its structure. In this state, the liver may be reduced to one-half its normal weight and bulk. It is found to occur: 1. _Old age._ Hence this form of atrophy is sometimes called “_senile atrophy_.” With the loss of adipose tissue in advancing years, there is also a tendency either to _degeneration_ or _wasting_ (atrophy) of many of the organs, and especially of the liver. In this manner, the liver may be reduced to one-half its normal size and weight without any change of structure. 2. _Inanition_, arising either from an insufficient supply of food, or from diseases which interfere with the assimilation of food, may result in simple atrophy of the liver. 3. _External pressure_ may also produce the same result, as from tight lacing, pleuritic, pericardial, or peritoneal effusions, or from enlargement of organs, or presence of tumors near the liver. Simple atrophy is rarely attended with jaundice unless pressure upon the bile ducts has been such as to obstruct the flow of that fluid. =Acute, or Yellow Atrophy.= In this somewhat rare form of disease, the liver becomes rapidly atrophied, accompanied with jaundice and cerebral symptoms. After death, the organ is found greatly reduced in size, extremely soft and yellow, with no appearance of lobules, and upon microscopic examination, the secreting cells found more or less changed into granular matter and oil globules. The weight of the gland in these cases, may be reduced from three to four pounds, the average normal weight, to less than two pounds. This form of disease is frequently attended with hæmorrhages, particularly of the stomach and bowels, and in some instances, from the uterus or nose. Pregnant females suffering from this affection usually abort. Among the causes of this form of disease of the liver may be mentioned pregnancy, dissipation, constitutional syphilis, malaria, and the blood-poisoning of typhus fever. Females appear much more liable to the disease than males, and most persons attacked are under middle age.