2O2 Anatomy Applied to Medicine and Surgery. 



that portion of the liver at the suspensory ligament, with 

 veins belonging to the diaphragm, viz., the phrenic, the 

 musculo-phrenic, etc. Bile may still be formed to a slight 

 extent even in thrombosis of the portal vein. This depends 

 on the fact that the hepatic artery communicates with the 

 intralobular plexus of veins. Attempts have been made to 

 increase the number of channels for the collateral circula- 

 tion by suturing the great omentum to the peritoneal cover- 

 ing of the anterior abdominal wall, the portal system thus 

 communicating with the caval system through the epigas- 

 trics, etc. Wounds of the liver may be produced by the pas- 

 sageof heavy objects, such as a wheel of a loaded cart, etc., 

 over the hepatic region, or, wounds may result from sudden 

 severe blows on this region, or from penetration by a 

 broken rib, etc., and, when so inflicted, one of the causes of 

 death may be hemorrhage. The treatment, in hemorrhage, 

 is to expose the liver, and, with a deep-seated or a purse- 

 string suture, to close the wound in the liver tissues. When 

 the liver is wounded by a knife thrust through, say the fifth 

 intercostal space in the mammary region, or, the sixth 

 space in the axillary region, the structures divided in ad- 

 dition to the muscles and fasciae of these regions would be 

 the parietal layer of the pleura, the visceral layer covering 

 the lung, the lung itself, the pleura covering the base of 

 the lung, the diaphragmatic pleura, the diaphragm, the 

 peritoneum covering the under surface of the diaphragm, 

 and lastly, the liver. A wound situated a little lower 

 down would divide the same structures, with the excep- 

 tion of the lung and the pleural layers covering it. 



An Abscess in the liver may perforate the dia- 

 phragm and break into the pleura, the lung or the pericar- 

 dium, or, it may burrow into the stomach, the colon, or 

 the duodenum, or, possibly, involve the peritoneal cavity, 

 or the connective tissue of the posterior portion of the ab- 

 domen. 



