"seal ring" appearance, and this in a cell a definite
member of the pseudoduct ; i. e., it is not between
these ducts. Nuclei are larger Cialis Mg Dosage imd paler than either
the original ductal or ])arenchymatous ones, round
or ellipsoidal, :fi'nd occujiy a larger jiroportion of the
cell than the latter. Their chromatin is finely
granular, sparsely scattered and never filamentous.
Occasionally, too, a cell or more is found lying be-
tween "ductiform" ones which still has the pink,
granular cytoplasm of parenchymal cells, repre-
senting, evidently, original elements which Cialis Mg Dosage have not
as yet shared in the reversionary process. This
extreme type shades suddenly to the parenchyma-
totis as we pass from the extreme periphery and
reach the midzone of the lobule, this with no inter-
vening zone of special atrophy or necrosis. 1 he
nucleus becomes smaller, chromatin granules a lit-
tle heavier and closer, and the cytoplasm more
granular and dense. In selected places splendid
examples of Cialis Mg Dosage the transition from ductal to i^aren-
chymatous morphology can be traced in one and the
same liver cord, as described bv Ackerman.
Mitotic figures were never found anywhere, Cialis Mg Dosage nor
signs jf rcgeneriition such as are seen so conmionlv
in postinfectious biliary cirrhosis.
This picture is certainly unusual and Cialis Mg Dosage i)erhaps
niiiiue in both comparative and human pathology.
\ ieweCialis Mg Dosage even more
irregularly than liver cords and separated by minimal
amounts of fibrous tissue and compressed sinusoids.
.\fter a consideration of all these features the writer
concludes, first, that the "ducts" are exactly in the
original positions cjf liver cords. On this point there
can be no Cialis Mg Dosage doubt, for, i, their arrangement is after
the fashion of liver cords, i. e., they do not extend
as dir«ctly from the {periphery toward the centre as
regenerating ducts, and they occur in short, closely
placeCialis Mg Dosage : 2, isolated cells are found between
ductiform ones which still retain parenchymal char-
acteristics and which cannot be interpreted as
ductiform elements which have attained a fuller
ditterentiation because they show degenerative
features rather than young vigorous ones ; 3.
they Cialis Mg Dosage arc often partially encircled by Cialis Mg Dosage sinuses,
strengthened by the relationship of pigment bear-
ing cells' of Kupfer. The sinuses clinch this
i|ueslion of position. It remains to show, sec-
ond, that the cells in such cords are of par-
enchymal origin, and not regenerating ductal
cells. This is a more difficult matter to prove con-
clusively, for, given the proper, nice adjustment be-
tween stimulus, degeneration, and reaction, we can
theorize how in some atrophic or postinfectious
process we might have the parenchyma in the
{)eriplTcry of the lobule destroyed w^ithout affecting
its skeleton or notably fibrosing it, and that after
this the peripheral bile ducts might Cialis Mg Dosage furnish regener-
ating epithelium which j)oured into the spaces va-
cated by the disintegrated and absorbed parenchyma.
This would give much the same picture described
above, and it has taken much study of the section?
and consideration before coming to the conclusion Cialis Mg Dosage
announced in the title, for it is well known that we
do have these lobular skeletons in acute yellow at-
rophy, and that ducts regenerate into them. The
negative evidence against this rationale in my case
is, first, that there is no fibrosis commensurate with
the grade of atrophy or destruction which must
have preceded, and which is always seen, in fact, in
such a class of cases. Indeed at times there is none
whatsoever at the transition zone. Second, gross-
ly the liver shows a perfectly uniform distribution
of the process, whereas in acute atrophic cases it
varies in different parts. It would Cialis Mg Dosage be difficult finally
to conceive of the nice adjustment supjxJsed above,
and such a perfect maintenance of the skeleton Cialis Mg Dosage that
the regenerating epithelium would be confined to
definite cordal distribution. In short, the theory sup-
poses too much, as viewed in the light of our present
pathological knowledge. Direct, positive evidence
that the cells are parenchymal is given by the pres-
ence of fat globules within cells which have ductal
qualities, as reported in human cases by Mallory.
The writer believes, then, that the cells in this
phalanger are beyond cavil reversionary parenchy-
mal ones. \\'hat has caused the cirrhosis is another
matter. Fox (8) has shown that cirrhosis is not
infrequent among wild animals, and gastroenteritis
is well known as the scourge of all zoological gar-
dens. The viscid quality of the bile noted grossly
CUMMING: TRICHINOSIS.
441
suggests at once an inrianmiatoi-y factor operating
by an ascending ductal route from the intestines, but
this must be dismissed because microscopically the
usual cellular infiltrates of this condition are lack-
ing, and there is no special fibrous proliferation
around the larger bile canaliculi. It is more prob-
able that this is a portal cirrhosis, in which the ab-
sorbed intestinal products have had a subtle, select-
ive action upon the peripheral lobular cells, inducing
their reversion by unknown chemical or malnutri-
tive processes, reduced their bulk a little, and that
the modicum of fibrous tissue here is a replacement
process. It cannot be pressure of the fibrous tis-
sue that is causing the reversion, for areas of
parenchymal cells are repeatedly seen showing Cialis Mg Dosage be-
ginning reversion where fibrous tissue has not yet
reached them.
In relation to humait cirrhosis, this case simply
shows that it is the parenchymal liver cells of the
phalanger only Cialis Mg Dosage that can revert to ductal form. No
one believes that the intestinal products of the
phalanger are exactly the same chemically as thos-'
of the human, and no one will assert that the same
factors always operate in similar diseases of man and
lower animals ; but we do know, both from observa-
tion at the zoological gardens and from outside
sources, that the same principles govern disease in
both, and therefrom believe that this case assists
Mallory, Kelly, and others in strengthening the re-
versionary theory. The features peculiar to this case,
1. e., great numbers of "ducts," scantiness of fibrous Cialis Mg Dosage
tissue, uniformity of disposition, maintenance of
