antipathic, for any organic disease of the heart, with the exception of uncomplicated hypertrophy, and even that demands chiefly a regiminal treatment. No doubt, mere irritability of a heart organically diseased may lead to much disorder of its action, for which no other organ of the body can be blamed, and in that case, as well as in those of disturbance originating in curable disorders of other organs, we have homœopathic means which are capable of warding off the final sufferings. But what are we to do when the sufferings arise solely from the organic alterations in the heart as a hydraulic engine? It is at this point that physiologically acting, antipathic, expedients become indispensable during the brief period that remains for treatment of any kind. To the consideration of them I may recur at some future opportunity.

NOVELTIES ABOUT THE LIVER,

BY DR. J. RUTHERFURD RUSSELL.

In the annals of the liver we might read the history of science and the progress of human thought. It was probably first attentively scrutinized by the Augurs, the most primitive anatomists, and from its colour and shape political predictions were drawn, and inspiration given to the Moniteurs and Times of those days :—and

"When science from creation's face
Enchantment's veil withdrew,"

so far from the "glorious visions" yielding "their place to cold material laws," it was found that the more the matter was examined the greater grew the interest, and that one discovery only made way for another; so that although during the last two hundred years about one hundred and fifty treatises have been written, many of them by the greatest men of their age-such as Malpighi, Hoffmann, Haller-upon the structure and functions of this organ, yet it was reserved for a man of our own time to announce a series of discoveries about the uses of the liver, of so new and startling a character as to attract the attention of the world at large, and which, if confirmed, will place the name of Bernard beside that of Haller. Interesting, in a general way, as these dis

coveries are to all, they must have a special interest for us whose high prerogative it is to convert all that is true in the science of medicine into something fruitful in the great art of healing.

The liver is the largest gland in the body, even in adult life, although then very much smaller, proportionally, than in the fœtal condition; in the human species it is one third of the weight of the whole fœtus at the end of the first month, and one eighteenth at the end of the ninth month.* Its average weight in a healthy man is from three to four pounds; it measures about twelve inches in length, and six to seven inches in depth; its bulk corresponds to nearly one hundred cubic inches. This great mass is made up of a multitude of lobules, and the variation in its dimensions in different classes of animals depends much more upon the number of lobules than upon their size. Between the lobule of the liver of a mouse and of an elephant there is but a comparatively trifling difference, the enormous magnitude of the latter depends upon the enormous multitude of lobules. In some animals, as the pig, these lobules are distinct, but generally they are only discoverable by dissection. Each lobule may be looked upon as a little liver, and the anatomy of one is the anatomy of the whole. The fundamental requirements in a lobule are three-fold: 1st, Vessels to bring blood to it; 2nd, Cells to operate upon that blood; and 3rd, Vessels to carry away what has been analyzed by the cells. The analysis consists in the separation of bile, which flows off by the biliary ducts, and the formation of sugar, which passes into the venous blood and is carried on to the heart and lungs. The first set of vessels, or those which supply the liver, are the hepatic artery and the portal vein. The hepatic artery, a branch of the abdominal aorta, is the feeder of the liver; as such, it is distributed upon the coats of the ducts and capsule: after discharging its functions there its contents are collected by venous radicles and discharged into branches of the portal vein. The portal vein is formed by a union of all the veins of the intestines, except those of the kidneys and bladder. It comes direct from the * Burdach, vol. iii, p. 483.

seat of digestion, and contains the blood in its rawest condition. Its distribution in the liver is very peculiar, and unlike that of any other vein in the body. The ordinary office of veins is to collect the blood, not to distribute it, and in their course the branches naturally diminish in number and increase in size; but the branches of the portal vein ramify like an artery, and encircle the lobules-as represented in this woodcut.

This represents the branches of the portal vein in the liver of a pig forming an imperfect circle round the centre of the lobule where the hepatic vein lies, but is not represented in this plate.

The cells of the liver are the seat of the vital force which operates incessantly upon the blood, inducing in it, in a wholly mysterious manner, those molecular changes which it is the appointed office of the organ to effect in the general economy of the body. These cells are very minute, varying from 1-800th to 1-2000th of an inch in diameter.* Each cell contains a nucleolus of a circular or oval form, and about 1-3000th of an inch in average diameter. Besides these nucleoli the cells contain oil globules and granules of

* Dr. Handfield Jones, Philos. Trans. 1846,-49,-53, and Med. Chirurg. Trans. 1852.

yellow coloring matter, and are remarkable, as compared with other gland-cells, for the variety in their form and size, and their high refractive power. It has been, and still is, a disputed point, whether these little cells lie simply imbedded among the capillary vessels, or enjoy a private dwellingplace in what is called a basement membrane. Dr. Beale is decidedly in favour of the latter opinion, and represents the cells as occupying a tubular network radiating from the centre towards the circumference of the lobule like a spider's web. In the fœtus the distinction between the capillary and the tubular network is manifest, but the partition walls being of the most delicate material, what was originally an interlacement of tubes tends to become a common cavity, and it is very difficult to demonstrate this arrangement in the liver of the man. Whether such a net of fine tubes containing these secreting cells exists or not is not apparently a question of any great importance, except to the anatomist. It is enough for the physiologist that a mechanism exists by which the blood of the portal vein, loaded with the drainage of the stomach and bowels, should be exposed to the action of these resolving cells by which its division into blood and bile is effected. How it happens that the bile should percolate the walls of the capillaries and the blood flow onward, belongs to the elective affinities of the organism, which must be recognized as an ultimate fact, at which we may wonder but can never comprehend.

We have now arrived at the centre of the liver, to which the blood has been conveyed by the ramifications of the portal vein, to be exposed to the influence of the cells and decomposed. Let us trace the course of the vessels which carry out of the liver the two fluids separated from the portal blood. These vessels are the hepatic duct and the hepatic vein. The hepatic duct is a tube of a firm fibrous structure, dividing into branches which lie alongside the branches of the portal vein. In the fibrous walls of these tubes are a row of small apertures, which, on being traced, are found to lead into a corresponding number of little pouches. It has hitherto been generally believed, that these pouches were for secreting the mucus of the bile, but, as

Dr. Beale acutely remarks, a pouch with a very narrow neck would be a bad contrivance for a viscid secretion, besides, in those animals in whose livers these pouches are most numerous there is no corresponding increased viscidity of bile. It is more likely that they are diverticula or little gall bladders. This view seems highly probable when we consider the sudden and very copious secretion of bile which is observed to follow the taking of food. For example, Bidder and Schmidt (p. 166) observed, that while a dog fasting yielded 1,558 grammes of bile in an hour, the same dog, after drinking 185 grammes of water, yielded 5,165 grammes of bile in the same time. The manner in which the branches of the hepatic duct terminate has been much canvassed, and the opinion of many most distinguished investigators was in favor of the termination consisting in blind extremities; Dr. Beale, however, maintains that these ducts which carry off the bile are directly continuous with the tubes which contain the cells where the bile is secreted, and that he has succeeded in injecting the latter from the former. He has given some plates in which this is shewn.