THE LIVER. SECRETION OP BILE. 



589 



disposed ; whilst the yellow is the non-congested part, in which the biliary plexus 

 shows itself more- or less distinctly. Another very interesting form of Patho- 



Fig. 160. 



Fig. 161. 



A, lobules in the second stage of Hepatic Venom con- 

 gestion : B and c, interlobular spaces ; D, congested 

 intralobular veins ; E, congested patches, extending 

 to the circumference of the lobules ; F, non-congested 

 portions of lobules. 



A, lobules as they appear on the surface in a state 

 of Portal Venous congestion: s, interlobular spaces 

 and fissures; c, intralobular hepatic yeins, containing 

 no blood ; D, the central portions in a state of anaemia ; 

 z, the marginal portions in a congested state. 



logical change in the aspect of the Liver, which the knowledge of the structure 

 of the lobules enables us to comprehend, is that to which the name of Cirrhosis 

 has been given. This has been erroneously attributed to the presence of a new 

 deposit, analogous to that of tubercular matter ; but it is really due to atrophy 

 and partial congestion in the liver itself. It is described by Laennec as usually 

 presenting itself in small masses, varying in size from a cherry-stone to a millet- 

 seed, and scattered through the substance of the liver. When these are minute 

 and closely set, they impart what appears at first to be a uniform brownish- 

 yellow tint to the divided surface of the liver ; but when the tissue is more at- 

 tentively examined, their separation becomes evident. These small masses are not 

 distinct lobules in a variable state of hypertrophy (as supposed by Cruveilhier), 

 but small uncongested patches, composed of parts of several adjoining lobules; 

 and having one or more interlobular spaces for a centre; and the biliary plex- 

 uses of these, being filled with bile, give them their yellow color. On the other 

 hand, there is an atrophy, more or less complete, of the portions of the sub- 

 stance of the liver intervening between them ; so that the bulk of the whole 

 organ is much diminished very commonly to one-half and sometimes to one-third 

 of its original size. 



628. Among the most frequent of the pathological changes which the assist- 

 ance of the Microscope enables us to discern in the biliary cells, is that engorge- 

 ment with adipose particles, which is observable in . 

 the condition of the organ known as " fatty liver" 

 (Fig. 162). This state having been frequently ob- 

 served in individuals who have died of phthisis 

 or other diseases of the lungs involving deficient 

 respiration, has been imputed to a vicarious action 

 of the liver, which (as was supposed) made an effort 

 thus to discharge the hydrocarbonaceous matters 

 that should normally be eliminated by the lungs. 

 But such a view is inconsistent with various facts, globules. 



Fig. 162. 



