90 MODE OF SUPPORTING THE LIVER. 



The peritoneum of the right side of the diaphragm, and of the 

 abdominal muscles, as far down as the umbilicus, is extended 

 to the liver, and joins it on the convex surface immediately 

 opposite to the umbilical fissure. The peritoneum from the 

 left side of these parts does the same ; and as these reflections 

 of the peritoneum are continued from so low a part as the 

 umbilicus, they are extended not only to the convex surface 

 of the liver, but also to the great notch, and along the umbilical 

 fissure. 



From the umbilicus proceeds a round cord-like ligament, 

 which in the foetal state was a vein, that passes to the great 

 fissure of the liver, and along it. The process of the perito- 

 neum above mentioned is so connected with this cord, that it 

 encloses it in its lower edge, and the whole is called the falci- 

 form ligament of the liver. The cord, when named separately, 

 is the umbilical or the round ligament ; and the membrane or 

 lamina of the peritoneum forms the suspensory ligament. 

 Besides these, the peritoneum on the lower side of the liver is 

 so arranged, that it not only extends to the stomach, but to the 

 duodenum and the colon. 



By these ligaments the position of the liver must be fixed to 

 a great degree ; and there is one additional connexion, which 

 must have a great effect in retaining it in its proper situation. 

 The vena cava receives two or three great veins from the liver, 

 (vencB cavce hepatic<s,) at the place where it is in contact with 

 the posterior edge of that viscus : these veins of course pass 

 directly from the substance of the liver into the cava, and 

 connect it to that vessel. As the cava is supported by the heart, 

 and also by the diaphragm, it must afford a considerable support 

 to the liver. 



When the stomach and intestines are distended, they must 

 also contribute in a considerable degree to the support of the 

 liver. 



The liver has a strong tendency, when we are erect, to change 

 its situation ; and some considerable support is necessary to 

 counteract this tendency. It would move to the right, when 

 we lie on the right side, if it were not in contact with the ribs : 



