Family tendency to hypertrophic cirrhosis of the liver (Hanot's disease) / by James Finlayson.

  • James Finlayson
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Family tendency to hypertrophic cirrhosis of the liver (Hanot's disease) / by James Finlayson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    affected with this grave form of icterus, the ducts were found to be still pervious. From all this we may infer a great degree of variation as to the severity or extent and also as to the duration of the affection of the bile ducts, or the period in intra-uterine life when the disorder appears. It is also important to notice that Dr. Thomson shows that this defect is sometimes associated with other manifestations of develop- mental disorder. In my cases of hypertrophic cirrhosis the brother and sister were evidently under-developed, and in particular the girl, although 21 years old, had never men- struated. The remark already quoted from Hanot (p. 99), as to the disease occurring in badly-developed subjects, may be recalled in this connection. In Dr. Ormerod's paper (St. Bartholomew’s Hospital Reports. vol. xxvi., 1896) reference is made to the occurrence of cirrhosis of the liver in a young subject associated with a family tendency to some peculiar nervous disorder; but, in the absence of details, not yet published, it is difficult to estimate the value of this group of cases for our present purpose. In the same paper he quotes the experience of Prof. Homen (Neurologisches Centralhlatt, 1890, p. 514), where two members of a family had this combination of well-marked cirrhosis of the liver and some nervous lesion (in the lenticular nucleus) when examined after death; a third member of the family seemed to be similarly affected. The illnesses ran a chronic course of six or seven years, and proved fatal at the age of 26 and 19 years respectively. In the case of family cirrhosis we may suppose that a developmental defect occurs in the liver in certain members of the family; the mere fact of the common bile duct being found pervious at death in cases of hypertrophic cirrhosis (Hanot, p. 132) does not exclude the notion of a possible defect or peculiarity in the ducts determining a biliary cirrhosis. We know that very slip-ht obstructions interfere with the flow of bile, and some defect in the lumen of the ducts within the liver itself might lead to disorder. We have instructive analogies in the congenital defect of the bile ducts, already referred to, viz. cases with similar symptoms occurring at
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