THE LIVER IN ITS RELATIONS TO BACTERIA. 341 



seen; Kupffer found it to afford a direct channel between this 

 bile-reservoir and the bile-capillaries per se. 



The Hepatic Tissues in their Relations to Bacteria. A 

 prominent feature of the work so far done is the evidence 

 furnished that several physiological processes now ascribed to 

 the hepatic cell in no way involve this structure, and that the 

 portal vein itself and the intercellular 19 capillaries are the seat 

 of several of these processes. 



Before proceeding further, however, reference must be 

 made to the connection between bacteria and the normal liver. 

 We emphasize "normal" here, because we thus simultaneously 

 lay stress upon a feature which plays a predominating role in 

 disease: i.e., the fact that anatomically, as far as bacteria go, 

 there is no direct normal connection between the digestive 

 system and this organ. The liver, in fact, is essentially a 

 physiological organ in the sense that it is mainly intended to 

 rid the system of waste-products and to economize others that 

 may again prove useful, by preparing them for reabsorption 

 in the intestine. 



We have seen that the venules of the villi allow iron- 

 pigment leucocytes to enter the mesenteric veins which carry 

 their blood to the portal. A depraved condition of all the 

 digestive structures such as that induced by alcoholism, for 

 instance can so lower the functional activity of these struct- 

 ures as to cause these venules to lose their normal turgescence 

 and afford passage to bacteria, alcohol in large doses being 

 known to impair metabolism. The intestinal venules under 

 these circumstances, surrounded by weakened protective struct- 

 ures, can well give passage to Adami's cirrhosis bacillus, for 

 instance, or any other capable of coping with what prophylactic 

 conditions may still prevail. "The portal vein can transport 

 to the liver morbid germs from the intestinal surface," says 

 Labadie-Lagrave. "One of the best established pathogenic 

 connections of this kind is the influence exerted upon the de- 

 velopment of hepatitis by dysentery; although this relation- 

 ship is not constant, all observers have noted it. Phlebitis 



19 We find it necessary to give the terminals of the portal this name in order 

 to avoid confusion; they contain blood from both the portal and hepatic chan- 

 nels, and in reality form part of both as extensions. S. 



