In the last ten or fifteen years a voluminous literature has been accumulating with regard to the effect of chronic irritations and destructive processes on the development of cancer. The relation between normal, hyperplastic, adenomatous and cancerous changes is still extremely obscure, but it is highly probable that there is a definite connecting link. Where the boundary line between a benign and a malignant cell can be drawn, and what agencies or conditions are responsible for the change from the one to the other, are questions on which diverse opinions are held. The work of MacCarty1 and Broders2 on cellular pathology and on the factors influencing malignancy are important. Primary carcinoma of the liver occupies a unique position among malignant tumors, not only on account of its rarity but also from its habits of growth and spread, and from its frequent association with cirrhosis. In studying the five cases reported