186 



ABNORMAL ANATOMY OF THE LIVER. 



formes acini, in figuris ramosis et foliatis varie 

 dispositis." Now the truth is, that this section 

 is in the second stage of hepatic venous con- 

 gestion, and the " figuris ramosis et foliatis" 

 are simply the uncongested portions of the 

 lobules, of a lighter colour than the rest, and 

 presenting the foliated and ramous appearance 

 which is common to this form of congestion. 

 The " fines ductuum biliferorum elongati seu 

 cylindriformes acini" are obviously imaginary. 

 The dark lines in the centre of the foliated ra- 

 mifications are small branches of the portal 

 vein lodged in interlobular fissures. If the 

 twigs given off by these branches be made to 

 unite with each other, we shall then have the 

 true form of the lobules. This has been done 

 in Jig. 45, upon a part of Miiller's drawing, for 

 the purpose of shewing how the error has 

 arisen, and how the form of the lobules may be 

 restored. This appearance of the congested 

 liver is by no means unfrequent in occurrence, 

 and I subjoin a careful and accurate drawing 

 of a similar arrangement in the human liver, 

 (./?. 46,) for the purpose of comparison with 

 that of Miiller. 



Fig. 46. 



Section of a portion of liver exhibiting hepatic venous 

 congestion in the second stage, carefully delineated 

 from nature by Bagg, and intended to be compared 

 with Mutter's Jigure. 



a, The portal vein in an interlobular fissure, giv- 

 ing off small twigs to adjoining fissures, and sur- 

 rounded by the uncongested portion of the liver. 

 b, The form of a few of the lobules is shewn, c, Ir- 

 regular patches of uncongested liver, as in Miiller's 

 figure ; the space in the centre of each being an 

 interlobular space, d, Interlobular spaces. e,The 

 congested portion of the liver. 



Coming from so high an authority as Miiller, 

 this figure has been copied without hesitation 

 by several writers, together with the explanation 

 given of it by the author. Mr. Grainger has 

 introduced it into his article upon the glands in 

 this Cyclopedia, v /?g. 217, page 485, and Mr. 

 Carpenter has also given it a place in his recent 

 excellent work * on physiology. In his text, 



* Principles of General and Comparative Phy- 

 siology, 1839. 



the latter gentleman observes with regard to the 

 figure : " In the squirrel indeed these pro- 

 longations may be distinctly seen, the blind 

 sacs being cylindrical in form, and closely 

 packed together." 



Hepatic venous congestion in its most com- 

 mon form, viz., in the second stage, is the great 

 stumbling-block of all anatomists who have 

 engaged in the investigation of the minute 

 anatomy of the liver; and it is under this 

 head that I must now consider the views of 

 Cruveilhier with regard to the supposed nor- 

 mal anatomy of this organ. Isolated from the 

 distribution of the vessels in the liver, he has 

 described the form and arrangement of the 

 lobules with sufficient accuracy ; but then it 

 must be remembered that his description was 

 written subsequently to the publication of the 

 researches of Kiernan. But his conception of 

 the structure of the lobules is completely erro- 

 neous, for after combating the common error 

 of the existence of two distinct substances, he 

 says : " Les deux couleurs jaune et brune 

 quand elles existent, n'appartient pas a deux 

 granulations distinctes, mais bien a la meme 

 granulation qui est jaune au centre, ou se 

 trouve le bile, et rouge-brun a la circonference, 

 ou se trouve le sang." Now Kiernan has dis- 

 tinctly proved that the structure of the lobules 

 is the same throughout, and their colour is 

 also uniform. Cruveilhier must therefore have 

 founded his opinion and his description upon 

 a liver in the second stage of hepatic conges- 

 tion, in which there exists a delusive indication 

 of lobules having the appearance of small oval 

 and variously shaped patches, of a yellowish 

 colour, situated at regular intervals, and sur- 

 rounded by a reddish brown substance. These 

 yellowish spots are seen in Jigs. 43, 45 & 46. 

 They are the clusters of terminal biliary ducts 

 of Miiller, the central portions of the lobules 

 of the liver of Cruveilhier; but if they be ex- 

 amined carefully, their true nature will become 

 clearly apparent. They are actually the un- 

 congested portions of the lobules of a liver in 

 the state of hepatic venous congestion at the 

 second stage, and have each an interlobular 

 space for a centre. In the next passage Cru- 

 veilhier observes: " Le foie humain, excepte 

 dans les cas de development considerable des 

 granulations, se prete difficilement a leur etude 

 vu leur petitesse." Here again in the words 

 " development considerable," we perceive an 

 idea founded upon the same erroneous im- 

 pression with regard to the structure of the 

 lobules. The real lobules are as nearly as pos- 

 sible of the same size in the liver of every 

 individual, but these imaginary lobules of 

 Cruveilhier, having uncongested portions of 

 the hepatic substance for centres, necessarily 

 vary in size and form with the degree of con- 

 gestion, and hence have given rise to the idea 

 of an increased development of the lobules. 

 Again, the true lobules are not so small in the 

 human liver as to render their examination 

 difficult ; they may be seen distinctly with the 

 naked eye, and with the commonest lens may be 

 examined accurately. But in the congested 



