Inflammations of the liver, and their sequelae : atrophy, cirrhosis, ascites, haemorrhages, apoplexy, and hepatic abscesses.
- George Harley
- Date:
- 1886
Licence: Public Domain Mark
Credit: Inflammations of the liver, and their sequelae : atrophy, cirrhosis, ascites, haemorrhages, apoplexy, and hepatic abscesses. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![7S lieve erroneously given as an example of death from the entrance of hydatid fluid into the trunk of the portal vein: My opinion is, that the death of the patient was due to the entrance of air into the hepatic vein. For even had air entered the portal vein, I cannot see how it could possibly have arrived at the patient's heart, after travers- ing the muiute capillaries of the glandular structure of the hver, which it would be forced to do, in the form of sufliciently large air bubbles as would suffice to prove fatal to hfe. In the case of the hepatic vein, on the other hand, it would be quite] different, as between its trunk and the heart there is no intervening net-work of fine capillaries to subdivide the air globules. However, be that as it may, there was I knew no necessity of ray running tliis risk. All that was necessary in order to avoid it being to take the precaution of guiding the point of the trocar in such a direction as would preclude the possibility of its encountering the large blood vessels which are situated in the neighbourhood of the trans- verse fissure. Consequently, all I had to do to prevent the entrance of air was to direct the point of the instrument while penetrating the organ in a fine between the centre and the upper convex border of the hver, in which posi- tion there are exceedingly few, if any, large vessels at all. The danger the patient ran in thus performing the opera- tion I, consequently, considered to be but trifling when compared to the advantages, I was sanguine enough to anticipate would follow upon the free extraction of blood from her inflamed liver. Looking forward, then, with confidence to the result, no sooner had I pushed the in- strument home to its hilt, than I began slowly and deU- berately, with a rotatory movement, to withdraw it, in the hope that sufficient blood would ooze from the wounded vessels into the channel left by the receding](https://iiif.wellcomecollection.org/image/b21219722_0092.jp2/full/800%2C/0/default.jpg)
