PECULIAR FORM OF HEPATITIS WITH NECROSIS.

Curschmann¹ describes a form of necrosis and inflammation in the liver which, beginning in the center of the lobules, may spread so as to involve the whole organ, death resulting from a species of marasmus due to suspension of the internal secretion of the liver. The process develops after occlusion of the large bile passages, as a result of the lodgment of calculi; the obstruction, however, does not need to be permanent; at the time of death there may be no biliary obstruction and no icterus; and yet biliary obstruction does play an essential rôle, because the bile passages are found to be dilated clear out into the interlobular branches, and because there is connective tissue proliferation about them, the additional factor, which directly produces the extensive necrosis, being in all probability toxicogenic bacteria whose entrance is favored by the occlusion of the biliary ducts. It evidently concerns the