590 OF SECRETION AND EXCRETION. 



which show (as Mr. Paget has justly remarked 1 ) that the fatty liver is an inactive 

 organ, one which is discharging less than its ordinary function, and that the accu- 

 mulation of fat in its cells is rather to be considered as a mark of " fatty degene- 

 ration. " For the nuclei disappear, the proper coloring matter of the bile can 

 no longer be distinguished, the liver increases in size owing to the tardy or 

 obstructed removal of its cells, and its paleness indicates a slow and defective 

 supply of blood; moreover, the fatty liver presents itself in many cases in which 

 there has been no deficiency of respiration, and is frequently absent in phthisical 

 subjects; and there is no evidence whatever that the organ when in this state 

 discharges any unusual amount of fat into the alimentary canal. Still there 

 can be little doubt that the accumulation of adipose matter in the biliary cells 

 is favored by deficiency of respiration, since this will tend to increase the quan- 

 tity which the circulating fluid contains. Throughout the Animal series, more- 

 over, a marked relation of reciprocity is discernible between the amount of fat 

 contained in the Hepatic apparatus, and the activity of the respiratory function ; 

 thus in Birds, the biliary cells scarcely contain any fatty particles, whilst in 

 Reptiles and Fishes they are loaded with them ; and nearly the same difference 

 may be seen between the biliary cells of Insects and those of Crustacea and 

 Mollusca. Various other alterations, however, have been noticed. Dr. T. 

 Williams mentions 3 that, in a case of obstruction of the ductus choledochus by 

 malignant disease, which occasioned complete interruption to the passage of bile, 

 and consequent jaundice, scarcely an entire nucleated cell could be discovered 

 by attentive examination of a large part of the organ. Nothing more than 

 minute free particles of fat, and free floating amorphous glandular matter, could 

 be detected. He further states that, in a case of fever, the hepatic cells were 

 found to be almost entirely destitute of fatty particles; and that in what is known 

 as "granular liver," the granules (which have much the appearance of tubercles) 

 consist of cells, which strongly resemble the ordinary cells of the parenchyma 

 of the liver in every respect, except that they are almost or completely destitute of 

 yellow contents. Similar observations have been also recorded by Dr. G. Budd. 3 

 In two cases of jaundice examined by Mr. Gulliver, the hepatic cells were 

 gorged with biliary matter ; some of them to such an extent that they had 

 become nearly opaque. Perhaps, if this condition had continued, these cells 

 would have been all ruptured, and the state of the organ would have resembled 

 that described by Dr. Williams. 



629. Previously to birth, the Liver is the only decarbonizing organ in the 

 system, the lungs being at that time inert ; and nearly the whole of the blood 

 returning from the placenta passes through this organ before proceeding to the 

 heart, to be distributed by it to the body generally. The liver of the foetus, 

 moreover, is considerably larger in proportion than that of the adult; and its 

 functional importance is obviously great. There can be no question that the 

 secretion of bile is actively taking place during the latter part (at least) of foetal 

 life ; for a large accumulation of it presents itself in the intestinal canal of the 

 new-born infant the meconium having been found by the analyses of Simon 4 

 and of Frerichs 5 to be chiefly made up of the characteristic components of the 

 biliary secretion. As soon, however, as the placental circulation is cut off, and 

 the Lungs of the infant come into play, the supply of blood transmitted to the 

 liver is almost immediately lessened ; this diminution being usually made very 

 evident within a short time after birth, by the comparative paleness of the sub- 

 stance of the gland. It has been proposed to give this fact a practical bearing, 



"Lectures on Nutrition," &c., in "Medical Gazette," 1847, vol. xl. p. 235. 



" Guy's Hospital Reports," 1843. 



See his Treatise on "Diseases of the Liver," 2d edit., pp. 211, 247, &c. 



"Animal Chemistry," translated by Dr. Day, p. 672, Am. Ed. 



Dr. Day's " Report on Chemistry," in " Ranking' s Half-yearly Abstract," vol. iii. p. 314. 



