Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis.

  • Pierre Charles Alexandre Louis
Date:
1844
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Licence: Public Domain Mark

Credit: Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    CHAPTER V. BILIARY ORGANS. SECTION I. LIVER. Fatty transformation of the liver ranks as the most frequent and most remarkable anatomical change of this viscus. It ex- isted in a third part of the cases^ or in forty of one hundred and twenty. When thus diseased, the liver was pale, almost always of a fawn colour of variable delicacy, and studded mth red points externally and internally. The usual shape of the organ was re- tained, but its size almost invariably increased, sometimes even to nearly twice the natural amount,—an enlargement principally implicating the right lobe. Under these circumstances the liver overlapped a great part of the anterior surface of the stomach, filled the epigastrium, protruded two or three fingers' breadth below the false ribs, reached in some subjects the crista of the ileum inferiorly, and on the left side the spleen,—sometimes even passing beyond that organ. In one case I found it seated in the middle of the abdomen and about two inches and five lines [6 centimeters] distant from the pubis. Its consistence, unless in a few cases where the morbid change was unadvanced, had fallen considerably below the natural standard; the tissue was easily broken down, and in some cases very soft. In cases where the transformation was far advanced, the tissue greased the knife and the hands like ordinaiy fat; when less advanced the nature of the change was ascertainable by placing a small slice of the liver on a sheet of paper and ex- posing this to the flame of a taper;—a slight degree of heat melted a small quantity of fat, this then stained the paper, and thereby disclosed its own presence.—This morbid condition in- variably implicated the entire of the viscus. The causes of fatty transformation of the liver appear to me as obscure as those of other organic diseases. Without aiming, then, at the solution of this problem, I shall state the principal