Remarks on the functions of the liver in jaundice / by J. Wickham Legg.

  • Legg, J. Wickham (John Wickham), 1843-1921.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the functions of the liver in jaundice / by J. Wickham Legg. 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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    bile-acids become less in quantity, and, as Golowin has found, even dis- appear from the urine altogether at the end of a long-continued jaundice. The same reasoning may be applied to the bile-pigments ; their source, however, is altogether different from that of the bile-acids, for it is probable that they are derived from the red corpuscles of the blood. There can be little doubt that the formation in the liver of bile-pigments must be decreased both from the small amount excreted by the kidneys and the slight staining of the tissues even in severe jaundice compared with what would take place were the whole of the bile-pigments formed in health again passed into the blood. The colour of the patient would then be an Ethiopian black- ness. Clinical observation also shows that the colour of jaundiced pa- tients decreases as death draws near. A third important function is, that the liver produces a large amount of heat. Bernard, some years ago, pointed out that the temperature of the upper part of the vena cava inferior was higher than that of any other part of the body. This high temperature is, no doubt, due to the active chemical changes continually going on in the liver ; and, if these changes cease, it must follow that the temperature itself would fall likewise. I have found, in some cases that I have examined, the temperature in the upper part of the vena cava inferior, forty-eight hours after ligature of the common duct, lowered to the temperature of the rectum. This lowering of the temperature is not, however, constant, and the investigation requires to be pushed farther than at present I have had the leisure to pursue it. It has been long known that in jaundice the temperature of the body is below natural, provided the jaundice be not accompanied or caused by any disease which of necessity begets fever. The lowering of the temperature in the hepatic veins, if confirmed, would serve to explain the low temperature of the whole body so commonly seen in jaundice ; for, if the liver be the great heat-giving centre of the body and it cease to give out heat, what sequence more natural than that the temperature of the whole body should be lowered ? Another revived Galenical function of the liver is its power of form- ing blood-corpuscles. It is well known that the blood of the hepatic vein contains a far greater number of both red and colourless cor- puscles than that of the portal vein. The corpuscles of the portal vein show likewise under the microscope a more distorted shape than the blood-corpuscles of the general system ; they are also richer in fat.