LIVER. 



differing confidi-rably in their properties, aiid dHlinpuifhed 

 by tlie names ol" hepatic and cyllic. The former, which is 

 containi-d in the hepatic duft, and in tlic branches of that 

 tube dillributed through the liver, approaches in fluidity to 

 water, is of a bright orange colour, and not bitter : fo far, 

 indeed, is it from containing any qualities ofienfive to the 

 tafle, that the livers of animals, which mull always contain 

 nuich of it, are commonly employed tor food. The latter, 

 or bile of the gall bladder, is a thick ropy fluid, of a deep 

 orange brown, or even green tint, and moll intenfely bitter. 

 Both thefe kinds are fecreted in the liver, and originally 

 are not different. The gall-bladder receives what it con- 

 tains through the cyllic duft, and produces in it the changes 

 jull delcribud while it remains in this rclervoir. A copious 

 mucous fecretion takes place from its lining, and the aqueous 

 parts of the bile are removed by the numerous and large 

 abforbents of the receptacle. The cyllic bile is, therefore, 

 nothing more than hepatic bile in a concentrated rtate. It 

 is eafy to prove that the gall-bladdtr can receive bile only 

 through the cviHc duct : we have already obfcrved, that 

 the liepatico-cyllic duCls are imaginary ; we may add, that 

 if the bladder be removed with its contents, the cyftic duel 

 tied, and ijreiiure then applied to the part in every direftion, 

 not a panicle of the fluid efcapes. If the /:yllic duft be 

 obllrutted by a calculus, or obliterated by dil'eafe, no bile 

 is contained in the gall-bladder, which, on the contrary, is 

 filled with a colourlefs mucus, if we evacuate the receptacle 

 in a living animal, and tie its duft, it will be found under 

 the fame circumllances ; and the cyllic duct, from its open- 

 ing into the hepatic to the ligature, will be dillended. 



The gall-bladder, from the view of its funttions, does not 

 feem to be a very important organ in the economy. Several 

 animals, among the mammalia, do not poffefs it, as the horfe, 

 ftag, elephant. No ill effects have been obferved, where 

 the cyllic dn£l has been obliterated ; nor where there has 

 been a natural deficiency of the organ. 



That the fluid fecreted in the liver flows in part direftly into 

 the intelline, would be naturally inferred from obferving the 

 fize and favourable direftion of the hepatic dutl for this courfe, 

 and the comparatively unfavourable direction, tortuous courfe, 

 and fmall diameter of the paffagc leading into the gall-bladdeiv 

 Thefe circumllances, indeed, would lead us to expeil that the 

 bile would enter the gall-bladder in very fparing quantity. If 

 an animal be opened, when the inteilinal functions are not 

 going on, the hepatic duft, and the duftus choledochus, con- 

 tain hepatic bile ; the furface of the duodenum and jejunum 

 is tinged with the fame kind of fluid ; and the gall-bladder 

 is dillended with cyllic bile, of which the properties are the 

 more llrongly I'larked in proportion to the length of the 

 previous abllinence. While the ftomach is e.xerrtng its 

 action on the food, the fame appearances are exhibited. 

 When the aliment has paffed into the duodenum, the ductus 

 choledochus contains dark-coloured cyllic bile, and the gall- 

 bladder is lefs full. At the end of digcilion, and a little 

 after, the hepatic and common duels, and the gall-bladder, 

 all contain a light -coloured bile ; which is obferved alfo in 

 the duoderuim. The gall-bladder is flaccid. Thefe obfer- 

 vations arc deduced from experiments made by Bichat, and 

 recorded in his Anatomic Generale, p. 459. •' They were 

 repeated,"' fays he, " a great number of times, and fliew 

 clearly, that the fecretion goes on to a certain amount at all 

 times, but that this quantity is increafed during digeilion. 

 The bile furnidied when the action of the intelline is not 

 going on, is divided between the intelline, which is always 

 coloured by it, and die gall-bladder, which retains it with- 

 out pouring out any through the cyllic dudl : while it is 

 thus retained, it acquires its acrid charailer, deep tint, and 



the properties which feem to be required for the pnrpofes of 

 the digeilion that is to enfue. When the food, after under- 

 going the aAion of the ilomach, enters the duodenum, all 

 the hepatic bile flows into the intelline, and even in greater 

 quantity than before. The gall-bladder at the fame time 

 pours out its contents. When the aiftion of the intelline is 

 concluded, the quantity of fluid fecreted by the Irver is dimi- 

 nifhed, and it flows partly into the duodenum, and partly 

 into the gall-bladder, whereit is then feen in fmall quantity, 

 and of a bright colour, becnufe there has not yet been fuf- 

 ficicnt time for it to be colleiled more abundantly, nor to 

 acquire a deeper colour." liichat is of opinion that the 

 Ilomach always contains a certain quantity of bile. " In 

 its empty ilate," fays he, " we always find in it more or 

 lefs mucous fluid, fometimes mixed with fmall globules of 

 hydrogen gas, and almoll alwavs tinged of a yellowilh colour 

 by bile, which has entered through the pylorus. Haller fay.-i, 

 that this reflux does not always take place; but it is con- 

 llant, according to Morgagni. I have opened no dog where 

 it could not he manifellty difcerncd in the empty ftomacli, 

 particularly when it had been long empty. The bodies of 

 perfons, who die of difeafe, are not ht for deciding this 

 quelliou, as the diieafe may alter the courfe, nature, and 

 colour of the bile. When the ftomach was full, I could 

 not fometimes afcertaiii the prefence of bile : in other in- 

 llances I obferved a yi-ilowifli fluid between the alimentary 

 mafs and the coats of the ftomach. The bile entering the 

 ftomach has always appeared to me, from its colour, to be 

 hepatic ; I have never feen that dark fluid which is con- 

 tained in tlie gall-bladder, and which is vomited in fome 

 difeafes. This accords with the obfervation made above, 

 that hepatic bile only enters the duodenum during ab- 

 ftinencc. It is evident that the paffage of the food from 

 the ftomach, at the commencement of inteftinal digeftion, 

 at which time cyllic bile certainly flows into the duodenum, 

 muft prevenc that bile from going through the pylorus." 



We have mentioned, in the article Dige.stios, the effcfts 

 produced on the contents of the intelline by the admixture 

 of the biliary fluid. On this fubjeft, indeed, the amount 

 of our knowledge is very trifling : that the prefence of the 

 fluid is effcntial to the right performance of the inteftinal 

 fundlions, and that the colour of the fjcces is derived from 

 its admixture, are obvious fatts, and they include nearly all 

 that is hitherto proved. 



The chemical compofition of the fluid is confidercd under 

 the article Bile. 



The fympathies of the liver, with other organs, are very 

 numerous and important ; and render its phyfiology very 

 interelling to the phylician. It is connected primarily or 

 fecondarily, as caule or effecl, with various diforders of the 

 head, cheft, and abdomen. 



LlVEU, Chromatic difeafes of the, in Medicine. — Having 

 already treated of the acute inflammatory affections of the 

 liver (fee Hkpatitls), and of the various obftruclions to 

 the exit of the Wle into the intelline.^, which give rife to 

 Jaundice (fee that article) ; it remains for us to defcribe, 

 in this place, the other morbid changes to which this organ 

 is liable, and which are of a (low or ihronic kind. Thefe 

 are, principally, the flow inflammation cf the liver, or 

 chronic hepatitis, as it has been called ; induration, or a 

 fcirrhous ftate ot the organ ; foftnefs of it ; enlargement, or 

 diminution of its bulk ; the formation of tubercles in it ; 

 adhelions of it to the contiguous parts, &c. The formation 

 of thofe veficular cyfts, which are denominated hydatids, in 

 the liver, has been already difcuffed under ilie general head. 

 Sec Hydatids. 



'i'he chronic inflammatioQ of the liver is a difeafe, which 



is 



