THE LIVER SECRETION OF BILE. 



519 



Fig. 145. 



A, Lobules in the second stage of hepatic venous A, Lobules as they appear on the surface in a 



congestion; B and c, interlobular spaces; D, con- state of portal venous congestion; B, interlobular 



gested intralobular veins ; i, congested patches, ex- spaces and fissures; c, intralobular hepatic veins, 



tending to the circumference of the lobules ; F, non- containing no blood; D,the central portions in a 



congested portions of lobules. state of anaemia; E, the marginal portions in a 



congested state. 



network, the isolated spaces between which are occupied by the non-congested 

 portions (Fig. 145). This is a very rare occurrence; having been seen by 

 Mr. K. in children only. These differences fully explain the diversity of 

 the statements of different anatomists as to the relative positions of the so- 

 called red and yellow substances ; for it now appears, that the red substance 

 is the congested portion of the lobules, which may be either interior or exte- 

 rior, or irregularly disposed ; whilst the yellow is the non-congested part, in 

 which the Biliary plexus shows itself more or less distinctly. 



657. Another very interesting form of Pathological 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 Conges- 

 tion 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 scat- 

 tered 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 attentively ex- 

 amined, 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 plexuses 

 of these, being filled with bile, give them their yellow colour. 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. 



658. The application of the Microscope to the Hepatic Cells, in various 

 states of disease, has afforded many facts of great interest. The fatty liver, 

 which is often found in the bodies of persons who have died from diseases ob- 

 structing the pulmonary circulation, has been shown by Mr. Bowman* to depend 



* Medical Gazette, Jan., 1842. 



