Report on the progress of human anatomy and physiology in the year 1844-5 / [Sir James Paget].

  • James Paget
Date:
1846
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of human anatomy and physiology in the year 1844-5 / [Sir James Paget]. Source: Wellcome Collection.

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    ments of all its measurable parts, is published by Theile.* He confirms Mr. Kiernan’s account of its lobular structure; for though lie admits that the investment of each lobule, which is so dense in the pig' and some other animals, maybe absent or very thin in the human liver, yet lie urges, and very rightly, that the latter is, by the arrangement of its vessels, divided into lobules, just like those of the pig and others. For in the human liver, as in theirs, each portion thus bounded by vessels, if not by a distinct capsule, is a miniature liver, having in itself a complete bile-secreting apparatus. He con¬ firms also the account of the hepatic cells being arranged in networks with a radiated plan; but he denies the existence of the vaginal branches and plexuses of the portal vein as described by Mr. Kiernan. These vaginal plexuses, he says, “ are derived, not from the portal veins, but from the hepatic arteries, from which they are completely filled when both arteries and veins are at the same time injected ; and when they appear to be injected from the portal vein, it is because the injection has passed through those vessels by which the blood of the hepatic artery is carried to the portal vein. The inter¬ lobular portal veins are therefore, he says, derived directly from the portal veins; and those which appear to be vaginal branches of the portal vein are its in¬ ternal roots, by which it receives the blood which has served for the nutrition of the hepatic ducts and other vessels of the liver. But that which is most new in his essay is the account of the glands of the biliary ducts. The ori¬ fices of these are, as Mr. Kiernan showed, arranged in two opposite rows through the whole extent of the ducts within the liver, as far as they can be dissected; an arrangement peculiar to the human liver. Their number is less in the human than in the other livers which Theile examined, but their form is more complex. They generally consist of an elongated tortuous canal, bearing alternate small sacculi and pedicled bunches of cellules; re¬ minding one of the Meibomian glands. These canals, moreover, branch, and their branches anastomose with one another, and with those of the adjacent glands. Such a net-like connexion of the gland-canals occurs within the Glisson’s capsule, investing the larger and middle-sized hepatic ducts; but it is most remarkably developed in the transverse fissure of the liver. Here, after the hepatic duct has been well injected, red streaks, forming plexuses, can be seen, which are nothing but large examples of these glands.f The canal¬ shaped glands in this situation are a quarter of a line in diameter, (in other parts they are from one fifth to one tenth); their walls are beset by pouches and bundles of sacculi, some of which are one sixth of a line in diameter, and there open into them at short intervals elongated glandules, just like those found in the prolongations of Glisson’s capsule, except in that they do not open directly into the hepatic ducts. KrauseJ suspects that these glands of the hepatic ducts, as well as the vasa aberrantia of Weber, are incompletely injected bile-ducts, [or, perhaps, they should rather be considered as such ducts imperfectly developed ; for if Krause’s account of the acinous structure of the liver be true, no line of essen¬ tial distinction could well be drawn between them and the more perfect ducts]. He holds still§ that all the bile-ducts have acini at or near their ends, having confirmed his opinion by recent numerous injections. He agrees generally with Kiernan and Weber’s account of the reticular arrangement of the minu¬ test hepatic ducts, having often seen this by injection; and he adds that, on many of those ducts he has injected, and has seen, after dissolving the injec¬ tion that was in them, regular round and oblong vesicles or acini, from 730 to of an inch in diameter; many of these acini, grouped upon their several ducts, compose each lobule, each group of acini having one duct, and therefore each lobule having probably several ducts, or roots of the hepatic * Wagner’s Handworterbueh der Physiologic, art. Leber. t E. H. Weber has described these as a part of the vasa aberrantia of the hepatic ducts, similar to those in the left lateral ligament and some other situations. See last Report, p.29. j Muller’s Archiv, Ileft v, 1846. § His former paper is in Muller’s Archiv, 1037 ; and the same account is given in his Haudbuch der Anatomic.