CHAPTER XX 



EFFECTS ON THE LIVER 



The effects of inanition upon the liver are of interest, since this gland forms 

 an important part of the digestive system. As will be shown, there are marked 

 hepatic changes associated with inanition and malnutrition of various types. 

 After a brief summary, these changes in the liver will be considered under (A) 

 total inanition, and (B) partial inanition. 



Summary of the Effects on the Liver 



In interpreting the data on loss of weight in the liver during the various 

 forms of total and partial inanition, it must be remembered that even under 

 normal conditions the liver is exceedingly variable in weight (ranking close to 

 the spleen in this respect), so that unless the observations are very numerous 

 the results may be influenced by chance variations. This will doubtless account 

 for a part of the apparently discordant results, which are also due to differences 

 in species, age and other conditions, as well as in the type and degree of inanition. 



On the whole, however, it is clear that in general the liver during inanition 

 suffers a marked loss in weight, usually relatively greater than that in the body 

 as a whole. This applies to total inanition (complete or incomplete), especially 

 in adult man and animals. In the young, the loss of weight in the liver is 

 often less marked, and under some conditions (in the young rat and during 

 adult compensatory hypertrophy) the persistent growth impulse of the liver 

 may even overbalance the tendency to atrophy, resulting in a gain. In experi- 

 mental inanition, it has been shown that the loss in weight of the liver is rela- 

 tively heavier in the early stages, probably due to the rapid loss of hepatic 

 glycogen and a part of the fat. 



During the various types of partial inanition the changes in the weight of 

 the liver are more variable, with a tendency to atrophy in malnutritional edema, 

 pellagra, beriberi and aqueous inanition (thirst). In rickets, the liver is fre- 

 quently enlarged, while in scurvy and other types the results are more variable. 



Changes in Structure. — The loss in the weight of the liver is invariably found 

 to be due to atrophy of the parenchyma, although this may be masked to some 

 extent by the frequent passive hyperemia and more rarely by fibrosis (cirrhosis). 

 The atrophy of the gland-cells concerns chiefly the cytoplasm, the nuclei being 

 more resistant. 



The changes in the hepatic gland-cell are usually complex, on account of its 

 varying content of glycogen, protein, fat, secretory granules, mitochondria, etc. 

 The changes in the fat content have been much disputed, partly because of 

 variation in different species. Apparently the incoming blood-fat (derived 



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