=Liver.=--In this organ, likewise, no change is found with sufficient
regularity to warrant its acceptance as a distinctive lesion of scurvy.
Fatty infiltration is, however, very common in the centre as well as in
the periphery of the lobules. It is frequently associated with
congestion, which may be so great as to lead to atrophy. In one case of
Aschoff and Koch the picture resembled that of primary liver atrophy.
The organ frequently contains extravasated blood or depositions of old
blood pigment. It should be noted that Boerich described early cirrhosis
in several of his cases, and that Aschoff and Koch record that one of
their severe, acute cases showed "a recent cellular cirrhosis." An
exceptional lesion is reported by Reinert--a "leucocytic" infiltration
of the liver and spleen occurring in a three-year-old child, and
resembling that seen in pseudoleukæmia. Finally, it should be remembered
in this connection that Hart and Lessing found calcium deposits not only
in the muscles and adrenal glands of their monkeys, but also in the
liver.
=The spleen= shares the general congestion of the internal organs. Sato
and Nambu invariably found large numbers of pigment granules in this
organ. Hirschsprung noted many Malpighian corpuscles, Reinert describes
a true hyperplasia of the splenic pulp, and others mention infarcts and
subcapsular hemorrhages.
=The kidneys= are often normal. On the other hand, various forms of
nephritis are found, with cloudy swelling or interstitial change--a not
infrequent complication of scurvy. More typical of the primary disease
are congestion and hemorrhages, the bleedings occurring either under the
capsule, into the interstitial tissues, or into the lumina of the
tubules. Hayem found fatty infiltration of this organ and Aschoff and
Koch a slight change of this kind in one case.
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