The anatomy of humane bodies epitomized wherein all parts of man's body, with their actions and uses, are succinctly described, according to the newest doctrine of the most accurate and learned modern anatomists / by a Fellow of the College of Physicians, London.

CHAP. XI.

Of the Liver.

THE Liver is seated in the upper and chief place of the Abdomen;* 1.1 namely about a fin∣gers breadth distance from under the Midriff, in the right Hypochondre, (under the short Ribs) which, being of a great bulk, it even fills, and reaches from thence towards the left side, a little beyond the Cartilago ensiformis, or pit of the Sto∣mach. Its upper part is convex or round and smooth, the lower side is hollow, lying on the right side of the Stomach and Pylorus, &c. Its lower edge reaches below the short Ribs (in a healthfull Man when he stands upright) and al∣most to the very Navel.

In Dogs and many other Brutes it is divided into divers Lobes,* 1.2 but in Man it is continuous;

only there is a little protuberance in its hollow side, whereby it is tied to the Caul, which Spige∣lius called a Lobe, and from him others, but it is improperly called so, and not at all like the Lobes in the Livers of Brutes.

It has three Ligaments (properly so called) which according to Dr. Glisson (de Hepate) are these.* 1.3 The first is called Suspensorium, for it ties up the Liver to the Diaphragm; it is broad, membranous and strong, arising from the ••erito∣naeum, and is not only fixed to the outer membrane of the Liver, but does indeed make it, and de∣scends even into it, and is strongly fastned to the common sheath or involucrum of the Vena cava (there where the umbilical Vein is continuous to it.) By this strong insertion it is the more able to bear up the great weight of the Liver.

The second is the Vena umbilicalis, which af∣ter the birth, closes up and hardens into a Liga∣ment. It is directly opposite to the former. It passes out of the fissure of the Liver and termi∣nates in the Navel. By this the Liver is kept from ascending upon the motion of the Dia∣phragm upwards in respiration.

The third is that whereby the Liver adheres to the Cartilago ensiformis. This is thin and flaccid, but yet strong, broad and doubled, arising from that Membrane wherewith the Liver is encompas∣sed, (according to Spigelius) of which it is a duplicature (according to Dr. Glisson.) This hinders it from fluctuating to one or t'other side, or towards the Back.

Besides these three Ligaments, it has several other connexions to the neighbouring parts, but they would improperly be called Ligaments.

Thus it is connected to the Vena cava, and Porta, to the Caul, and to several other parts either mediately or immediately.

It is covered with a very thin Membrane,* 1.4 which springeth from the first Ligament, (as was said before) which cleaveth firmly to the substance of the Liver. If it be separate at any time by a watrish humour, issuing out of the capillary Lym∣phaticks, watrish Pustules, by the Graecians cal∣led 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, are ingendered. If these break, the water falleth into the cavity of the Belly, and causeth that kind of Dropsie called Ascites.

Its substance or Parenchyma is red and soft,* 1.5 al∣most like concreted bloud, and may, when it is boiled, be easily scrap'd or brusht off the vessels. But though its Parenchyma look red, that is only from the great quantity of bloud that is poured into it from the Vena portae: for its proper co∣lour is pale, a little yellowish, such as the Liver is of when 'tis boil'd; and yet that yellowishness seems to be caused by the Bile passing through it; so that Malpighius thinks white to be its proper colour, and gives a far different account of its Parenchyma from others, whose observations by the Microscope Diemerbroeck thus represents (out of Malpig. lib. de Hepate, cap. 2.)

That 1. The substance of the Liver in Man is framed of Lo∣bules, and these are compounded of little Glands like the stones of Raisins, which look like bunches of Grapes, and are cloathed with a proper circumambient Membrane—2. That the whole bulk of the Liver consists of these little grape-stone-like Glands and divers sorts of Vessels; and hence, that they may perform together a common work, it is necessary that

there be a commerce betwixt these Glands and Vessels. 3. That the little branches of the vessels of the Porta, Cava, and Porus bilarius, do run through all even the least Lobules in an equal number; that the branches of the Porta do the office of Arteries, and that the Porta has so great society with the Porus bilarius, that both their twigs are straitly tied together in the same cover. 4. That the shoots of the said Vessels are not joyned by Anastomoses, but that the grape-stone-like Glandules, making the chief substance of the Liver, are a medium between the importing and exporting Vessels, so that by the interposition of these, the impor∣ters transfuse their liquor into the exporters. From these observations he concludes the Liver to be a conglomerate Gland, separating the Bile—and because it is usual for the con∣glomerate Glands to have, besides Arteries, Veins and Nerves, a proper excretory Vessel (as in the Pancreas, &c.) dispersed through their substance, and drawing out and carrying away the humour designed for them, this kind of Vessel in the Liver is the Porus bilarius with the Gall-bladder.]

And this is a very proba∣ble account of it.

It hath two sorts of Veins.* 1.6 In its upper part the Vena cava entreth into it, and spreads it self all through it in the lower as well as upper part. Into the lower side the Vena porta is inserted, whose branches likewise run through its whole Parenchyma. Of both these Veins more fully in the two following Chapters.

It has but very small and few Arteries,* 1.7 for the Porta serves it for an Artery, bringing bloud to

it. Those which it has, do all arise from the right branch of the Arteria coeliaca, (called he∣patica) there where it is joyned to the Vena por∣tae, whence being sustained by the coat of the Caul it ascends to the hollow of the Liver just by the Porta, on whose coat, with the bilary Ves∣sels, and the membrane of the Liver, it is wholly spent. For as was said, the Parenchyma is nou∣rished by the bloud brought by the Porta.

It has Nerves from the Intercostal pair,* 1.8 name∣ly one from the stomachical branch thereof, ano∣ther from the mesenterical (called hepaticus.) But the Nerves are extended only to the Membrane and vessels of the Liver, (as the Arteries were) so that the Parenchyma has but a very dull sense.

Till the ductus Thoracicus Chyliferus was found out,* 1.9 it was still believed that the Venae lacteae were inserted into the Liver, which was looked upon as the great organ of sanguification; but now 'tis known for certain that no Lacteae at all go to the Liver, but that those vessels which were ta∣ken for such, are Lymphatick vessels carrying from it a most lympid and pellucid juice. That they are dispersed in the Parenchyma of the Liver, has not yet been observed; but it is very proba∣ble that they arise from its Glands, and coming out of its hollow or lower side, with the Porta, they encompass it round as also the ductus Commu∣nis, passing mostly towards the Mesentery; and under the Vena cava near the Pancreas (that is knit to the Stomach and Duodenum) a great ma∣ny do pass over a certain Gland (sometimes two or three) lying under the Vena porta and often adhering to it, and from thence with many others passed by the Gland, they open themselves into

the receptaculum Chyli. That these vessels bring nothing to the Liver, and so cannot be Lacteals, is apparent; for if in a Live-creature you make a Ligature betwixt the Stomach and Liver, in that part of the Mesentery that knits the Liver to the Stomach and Intestins (in which Ligature let the Vena portae and ductus Communis be comprehen∣ded) these vessels will presently swell betwixt the Ligature and the Liver, but be empty on that side towards the receptaculum Chyli; and the same is evident from their Valves also which open to∣wards the said Receptacle, but hinder any thing from coming back from thence to the Liver.

Concerning these we shall forbear to speak here,* 1.10 designing a particular Chapt. for them, viz. ch. 14.

Hippocrates in lib. 4. de Morb. says,* 1.11 The foun∣tain of bloud is the Heart, the place of Choler is in the Liver; This comes very near the truth, as shall appear hereafter. But from Galen downwards it was generally held that the Mesaraick Veins re∣ceived the Chyle from the Guts and brought it to the Liver, where it was turned into Bloud, and carried from thence into all the parts of the Body by the Veins. Yea and after the Venae lacteae were found out, they would needs have them to termi∣nate in it, thinking it the sittest Bowel for san∣guification, and presuming that that task must be performed by some or other. It would be need∣less here to stand to confute these opinions, now that all the world is convinc'd of their falsity, and by what hath been already said they may suf∣ficiently appear to be erroneous, no Chyle at all coming to the Liver. How and where sanguifica∣tion is performed, we shall shew when we come to the Heart, and here we shall declare the true use of the Liver.

The Liver then being discharged from sangui∣fication,* 1.12 it serves to separate the Bile from the Bloud brought plentifully to it by the Vena por∣tae. Concerning the nature of this Bile there have been divers opinions. The Ancients (amongst whom was Aristotle) thought it to be a meer ex∣crement, and to be of no other use than by its acrimony to promote the excretion of the Guts. And this opinion prevail'd so long as it was be∣liev'd that the Liver had a nobler action than to transcolate this Choler. But now it being found out that it has no other office, it is believ'd that so bulky a Bowel was never made for the separa∣tion of a meer excrement, and therefore they think it to be a ferment for the Chyle and Bloud, where∣by if they were not attenuated and prepared, they could not be enspirited in the Heart. This new doctrine I shall give entirely out of Diemer∣broeck, p. 154.

The venous Bloud flowing into the Liver by the Porta out of the Gastrick and Mesaraick veins (and may be a little by the Hepatick artery) is mixed with an acrimoni∣ous, saltish and subacid juice, made in the spleen of the arterious bloud flowing thither by the Arteries, and of the animal spirits by the Nerves, which is brought into the Porta by the ramus Splenicus. Now both these being entred the Liver by the branches of the Porta, by means of this said acrimonious and acid juice, and the specifick virtue or coction of the Liver, the spirituous particles, both sulphureous and salt, lying hid in the said venous bloud, are dissolved, attenuated, and become also a little acrimonious and fermenting; a certain thin∣nest part whereof, like most clear water, being

separated from the other thicker mass of the Bloud by means of the conglobated Glands, plac'd mostly in the hollow side of the Liver, is carried from thence by many Lympheducts, as has been said. But the fermentaceous spirits of greater acrimony, mixed with the thicker and more viscid sulphureous juices (for Sulphur is viscid) and more strongly boiling, whenas through the clamminess of the juices in which they inhere, they cannot enter the conglobated Glands nor from them the Lympheducts, and through their fierce ebullition are separated from the Bloud (as Yest from Beer) these fer∣mentaceous spirits I say being sever'd with the juice in which they inhere, become bitter and are called Bile. Which Bile being transcola∣ted through the grape-stone-like Glandules into the roots of the porus Bilarius and of the Gall∣bladder, passes through them by the ductus Communis into the Duodenum or Jejunum, wher•• it is presently mixed with the pancreatick juice, and both of them with the alimentary mass con∣cocted in the Stomach, and now passing down this way, which it causes to ferment. And be∣cause at its first entrance it is more acrimoni∣ous, and has its virtue entire, and so causes the greatest ••bullition with the pancreatick juice, hence the milky juice contained in the mass concocted in the Stomach, is most readily and in greatest quantity separated in the Jejunum, and by innumerable Lacteal vessels, (which are more numerous in this than the other Guts) it is most quickly driven on towards the receptacu∣lum Chyli, and this is the reason that this Gut is always so empty. But in the following Guts

because the fermentaceous spirits are a little pall'd, the effervescency becomes slower and less efficacious, and the Chyle is more slowly separated from the thicker mass, and therefore they have fewer Venae lacteae. At length what remains of this fermenting matter is mixed with the thick faeces in the thick Guts, where by its acrimony it irritates them to excreti∣on.]

Thus far that perspicacious and judi∣cious Anatomist. And this I think is the best account hereof that has been given.

Notes

• * 1.1

  Its situati∣on.
• * 1.2

  Lobes.
• * 1.3

  Ligaments.
• * 1.4

  Its Mem∣brane.
• * 1.5

  Substance.
• * 1.6

  Veins.
• * 1.7

  Arteries.
• * 1.8

  Nerves.
• * 1.9

  Lymphe∣ducts.
• * 1.10

  The bilary Vessels.
• * 1.11

  Whether the Liver sanguifie.
• * 1.12

  The action of the Li∣ver.