CHAPTER XIV 

 USES OF THE LIVER DUCTLESS GLANDS 



Physiological anatomy of the liver Branches of the portal vein, the hepatic artery and the 

 hepatic duct Interlobular vessels Structure of a lobule Arrangement of the bile- 

 ducts in the lobules Anatomy of the excretory passages Gall-bladder, cystic and com- 

 mon ducts Chemistry of the liver Nerves and lymphatics of the liver Mechanism of 



the secretion of bile Quantity of bile Uses of the bile Properties and composition of 

 the bile Biliary salts Cholesterin and stercorin Bilirubin Tests for bile Excre- 

 tory action of the liver Origin of cholesterin Formation of glycogen in the liver 



Conditions that influence the quantity of sugar in the blood Ductless glands and internal 



secretion Suprarenal capsules Cortical substance Medullary substance Vessels and 



nerves Chemistry of the suprarenal capsules Addison's disease The spleen Fibrous 



structure Malpighian bodies Spleen-pulp Bloodvessels, nerves and lymphatics 



Chemical constitution Variations in volume Extirpation Thyroid gland Structure 

 Vessels and nerves Myxoedema Thymus gland Pituitary body and pineal gland 

 Acromegaly and giantism Internal secretion by the testes and ovaries. 



PHYSIOLOGICAL ANATOMY OF THE LIVER 



IN regard to the descriptive anatomy of the liver, it is sufficient to 

 state that it is situated just below the diaphragm, in the right hypochon- 

 driac region and is the largest gland in the body, weighing, when moder- 

 ately filled with blood, about four and a half pounds (2 kilograms). Its 

 weight is somewhat variable, but in a person of ordinary adipose develop- 

 ment, its proportion to the weight of the body is about as one to thirty- 

 two. In early life the liver is relatively larger, its proportion to the 

 weight of the body in the newborn child being as one to eighteen 

 or twenty. 



The liver is covered externally with peritoneum, folds or duplicatures 

 of this membrane passing from the surface of the organ to the adjacent 

 parts. These constitute four of the so-called ligaments that hold the 

 liver in place. The proper coat is a thin but dense and resisting fibrous 

 structure, adherent to the substance of the organ, but detached without 

 much difficulty, and very closely united to the peritoneum. This mem- 

 brane is of variable thickness at different parts of the liver, being espe- 

 cially thin in the groove for the vena cava. At the transverse fissure 

 it surrounds the duct, bloodvessels and nerves, and it penetrates the 

 substance of the organ in the form of a vagina, or sheath, investing 

 the vessels and branching with them. This membrane, as it ramifies in 

 the substance of the liver, is called the capsule of Glisson. It will 



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