On the shoulder-tip pain, and other sympathetic pains, in diseases of the liver / by D. Embleton.
- Dennis Embleton
- Date:
- 1870
Licence: Public Domain Mark
Credit: On the shoulder-tip pain, and other sympathetic pains, in diseases of the liver / by D. Embleton. 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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![portje, hepatic arter}', and bile duct, to the transverse fissure, where it enters the liver, and ramifies on the vessels/’ Oruveilhier* that the hepatic plexus of the sympathetic (which comprises the pneumogastric hepatic nerves), “gains the transverse fissure of the liver, divides like the vena portae and hejjatic artery, and may be traced, for some distance, in the cajisule of Glisson.” If we can argue analogically from the other jjneumogastric organs, we should conclude that the liver branches of the par vagum are guided, by the blood vessels enveloped in the capsule of Glisson, to the acini of the organ, ramifying within and around these, and that they are destined to the bile ducts, and their continuations down to the transverse fissure, and to the duodenum. We know alieady that the gall bladder and cystic duct are provided with plexuses proper to themselves from these and the sympathetic nerves. Now, the system of bile ducts constitutes the essential secreting portion, so to speak, of the liver, as the bronchi and air cells do of the lungs; the mucous membrane, with its gastric glands, of the stomach ; and the lining membrane and muscles, of the heart —and these are the parts, in these several organs, to which their })neumogastric nerves are distributed. But to prove or to disprove that the hepatie twigs ai‘e really given to the system of bile ducts, and the sympathetic twigs to the blood vessels, a more minute and correct anatomy is wanted. In the absence, however, of satisfactory anatomical in- formation as to the S3'mmetrical arrangement of the hepatic nerves of the par vagum in reference to the right and left lobes, it may not, perhaps, be unreasonable to conjecture that I the right vagus supplies mainly the right, and the left vagus i mainly the left lobe. For the liver, at an early period of foetal life, is an almost symmetrical organ, the two lobes being equal, or nearly so.j' Thus, this organ resembles the other member’s of the pneumo- j gastric series—the phar^’nx ami larynx, the trachea and lungs, the heart, the stomach, the kidnej’s, &c.—and these are all supplied, mainly on their right side by the right, and on their left, by the left ])ueumoga.stric. It is well under-stood that branches are interchanged from side to side, but a .symmetrical ariangernent of the nerves cori’espond.s,on the whole, to the symmetrical form of the organs. Is it likely, I would ask. * CruveiUiier’a Anatomv, vol. ii., p. 1162, Tweedie’s Library of Mediciae, 1842. t Quaiu’s Anatomy, 7tb Edit., Part HI., p. 879.](https://iiif.wellcomecollection.org/image/b22471911_0023.jp2/full/800%2C/0/default.jpg)
