DISEASES OF THE LIVER AND BILE-DUCTS. 



SECTION I. 

 DISEASES OF THE LIVER. 



CHAPTER I. 



HYPEEuEMIA OF THE LIVER. 



ETIOLOGY. The amount of blood in the liver may be increased by 

 greater afflux or by impeded efflux. The hyperaamia due to increased 

 afflux we term fluxion [determination], that due to obstructed efflux, 



Fluxion to the li ver results 



1. From increase of the lateral pressure in the portal vein. Under 

 normal circumstances, there is fluxion to the liver at each digestion. 

 The passage of fluids from the intestines to the intestinal capillaries 

 causes an increased fulness of the intestinal veins ; consequently their 

 contents are subjected to greater pressure, and are impelled more 

 strongly toward the liver. In persons who eat and drink immoder- 

 ately, this physiological fluxion becomes excessive, continues longer, is 

 often repeated, and, like other frequently-recurring hyperaemias, may 

 cause permanent dilatation of the vessels. 



2. There is fluxion to the liver, because its capillaries, which, under 

 normal circumstances, find a support in the parenchyma, dilate when 

 this parenchyma becomes relaxed, and then offer an abnormally slight 

 resistance to the blood entering the organ. The hyperaemia of the 

 liver occurring after injuries of that viscus, or in the vicinity of inflam- 

 mations and neoplasiae, appears to develop in this way. Perhaps those 

 cases induced by the use of spirituous liquors also belong in this class. 

 In all of these cases we have to do with an irritation of the liver, as 

 the alcohol is conducted directly to the liver by the portal vein ; the 

 first action of an irritant appears to consist in changes of the parev- 



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