A girl, aged 18, after two days’ illness, was admitted into Guy’s Hospital. She confessed to having eaten a piece of bread coated with phosphorus paste. She had great abdominal pain, and died on the seventh day after taking the phosphorus. A few hours before her death she was profoundly and suddenly collapsed. The liver weighed 66 ozs. The outlines of the hepatic lobules were very distinct, each central vein being surrounded by an opaque yellowish zone; when fresh the hue was more uniform, and the section was yellowish-white in colour. A microscopical examination of the hepatic cells showed them laden with fat globules, especially in the central parts of the liver. The microscopic appearances are also characteristic. In a case of suicidal poisoning by phosphorus, in which death took place on the seventh day, the liver was very carefully examined by Dr. G. F. Goodart, who reported as follows:-- “Under a low power the structure of the liver is still readily recognisable, and in this the specimen differs from slides of three cases of acute yellow atrophy that I have in my possession. The hepatic cells are present in large numbers, and have their natural trabecular arrangement. The columns are abnormally separated by dilated blood or lymph-spaces, and the individual cells are cloudy and ill-defined. The portal channels are everywhere characterised by a crowd of small nuclei which stain with logwood deeply. The epithelium of the smaller ducts is cloudy, and blocks the tubes in many cases. Under a high power (one-fifth) it is seen that the hepatic cells are exceedingly ill-defined in outline, and full of granules and even drops of oil. But in many parts, even where the cells themselves are hazy, the nucleus is still fairly visible. It appears to me that, in opposition to what others have described, the nuclei of the cells have in great measure resisted the degenerative process. The change in the cells is uniform throughout each lobule, but some lobules are rather more affected than others. The blood-spaces between the cells are empty, and the liver appears to be very bloodless. The portal canals are uniformly studded with small round nuclei or cells, which are in part, and might be said in great part, due to increase of the connective tissue or to a cirrhotic process. But I am more disposed to favour the view that they are due to migration from the blood-vessels, because they are so uniform in size, and the hepatic cells and connective tissue in their neighbourhood are undergoing no changes in the way of growth whatever. I cannot detect any fatty changes in the vessels, but some of the smaller biliary ducts contain some cloudy albuminous material, and their nucleation is not distinct. No retained biliary pigment is visible.”[309] [309] “A Recent Case of Suicide,” by Herbert J. Capon, M.D.--_Lancet_, March 18, 1882.