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. XIV.

Of the Gall-bladder and Porus bilarius.

FOR the receiving and evacuating of Bile there are two vessels or passages framed in the right and hollow side of the Liver, namely the Gall-bladder, and Porus bilarius. By this latter there flows a thicker but milder, by the former a thinner, more acrimonious and fermen∣tative Choler into the Intestins.

The Gall-bladder,* 1.1 called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in Latine Vesica bilaria, or Folliculus fellis, is a hollow Bag placed in the hollow side of the Li∣ver, and in figure representeth a Pear.

It is about two inches in length,* 1.2 and one in breadth.

By its upper part it is tied to the Liver,* 1.3 which doth afford it a hollowness to receive it; but the lower part which hangeth without the Liver, resteth upon the right side of the Stomach, and the Colon, and doth often dye them both yel∣low.

It hath two Membranes,* 1.4 the one common, which is thin and exteriour, without Fibres. This springing from the membrane of the Liver, only covereth that part which hangeth without the Liver. The other Membrane is proper.

This is thick and strong,* 1.5 and hath three sorts of Fibres; the outermost are transverse, the middlemost oblique, and the innermost streight.

Within, it hath a mucous substance or crust, engendred of the Excrements of the third con∣coction

of its Membrane, to withstand the acri∣mony of the Choler.

It hath two parts,* 1.6 the Neck and the Bottom.

The Neck is harder than the Bottom, and higher in situation.

It from the bottom by degrees growing nar∣rower and narrower, at last endeth in the Ductus communis, or the common passage of the Choler, which is inserted into the beginning of the Jeju∣num, or the end of the Duodenum.

This elongation of the neck of the Vesica fellea, is called Meatus cysticus, because it springeth from the Cystis.

The Choler is conveyed into the Vesica by ma∣ny very small roots,* 1.7 dispersed in the Liver be∣tween the branches of the Porta and Cava; they are so very small that they are scarcely discerni∣ble, but when they meet together, they make one pretty notable Trunk which is inserted into the Cystis near its Neck, with a Valve before its Mouth to hinder the regurgitation of the Choler. (For in the Jaundice the Choler does not return out of the Gall-bladder into the Bloud again, but either for want of a convenient ferment it is not separated from the Bloud, or when the neck of the Vesica is stopt that none can pass out of it into the Guts, then the Gall-bladder is presently so fill'd that it cannot receive any more; and so the Choler being forc'd to stagnate in its roots, is re∣ceived in by the branches of the Cava, and there∣by contaminates the whole mass of Bloud.) But though it be evident that the Choler is brought into the Vesica by this Pipe, yet if one open the Bladder to look for its Mouth in the Cavity, one shall hardly find where it is; which is no wonder,

seeing it is so difficult to find the insertions of the Ureters into the urinary Bladder, which are vastly larger than this. But Dr. Glisson says, that near its neck in the inside, there is a little spongy protuberance, into which this Trunk is pretty plainly inserted; and this protuberancy is the same that we called before a Valve.

It has been taught by several Anatomists,* 1.8 that its Neck or Meatus has sometimes two, sometimes three Valves to hinder the recourse of the Cho∣ler: but Diemerbroeck professes he could never find any, but only that the egress of the Vesica was very strait, and its Neck wrinkled. Dr. Glis∣son declares also that he could never discover any in it, but on the contrary, he has often with a slight compression of his fingers found, that the Choler will fluctuate to and again, out of the Cystis into the Meatus, and on the contrary, as also out of the Meatus into the Ductus communis and back again; so that he cannot believe there is any thing of a Valve in the whole passage. But one thing which he thinks has impos'd upon Ana∣tomists, is a certain fibrous Ring (or Sphincten as it were) which is seated just at the end of the Bladder and beginning of its Neck, which makes the passage betwixt them exceeding strait; but this cannot be a Valve, because as he observes the Choler will go either way through it.

The Vesica fellea hath two Veins called Cystica gemellae,* 1.9 which spring from the Porta.

It hath sprigs of Arteries proceeding from the right branch of the Coeliaca. And it hath a small thread-like sprig of a Nerve from the Mesenteri∣cal branch of the Intercostal.

Many times stones are found in it,* 1.10 which be∣ing lighter and more spongy than those of the Bladder will swim above water.

The other passage which carrieth the thicker sort of Choler,* 1.11 is called Porus bilarius, or Meatus hepaticus, because it passeth directly from the Liver to the Ductus communis.

Within the Liver its Trunk and Branches are invested with a double coat; its proper one, which it retains without the Liver also, and ano∣ther that is common to it with the Porta called Capsula communis, which it has from the mem∣brane of the Liver. In this common coat this Porus and the Porta are so closely enwrapped that you would take them but for one Vessel, till you either hold it up to the light, (which will disco∣ver Vessels of two colours in it) or very dex∣trously rip up the Capsula, and so lay them open. Its roots within the Liver are equally divided with those of the Porta every where, saving that little space where the roots of the Vesica are spread, in the simous and right side of the Liver. So that having spoken above of the divisions of the roots of the Porta, I shall refer the Reader thither for these of the Porus. I shall only ob∣serve that they are far larger and more numerous than those of the Vesica, drawing Choler from all the parts of the Liver (saving whither the roots of the Bladder reach) and that more thick and viscous, yet less acrimonious.

This Porus seems to be a more necessary part than the Vesica; for many Creatures, as Harts, Fallow-deer, the Sea-calf, &c. and those which have a whole Hoof, have no Gall-bladder, but there is none that is destitute of this.

Without the Liver it is as wide again as the Meatus cysticus, with which it is joyned at two inches distance from the Liver, and both make the Ductus communis choledochus. It has no Valve in its whole progress; only the Ductus communis, where it enters the Intestin, having pierced the outer coat, passes betwixt that and the middle∣most about the twelfth part of an inch, and then piercing that also marches down further betwixt it and the innermost coat about half an inch, and at last opens with a round mouth into the Intestin. So that this oblique insertion (as that of the U∣reter into the urinary Bladder) serves instead of a Valve to hinder any thing from regurgita∣ting out of the Gut into this Duct, especially the inmost Tunicle of the Intestin hanging so flaggy before its mouth, that when any thing would en∣ter in, it claps close upon it and stops it.

As to any anastomoses of the roots of either of these Bilary vessels with those of the Vena portae, such indeed have been much talkt of, but without truth, for their extream Twigs or Capillaries terminate in the Parenchyma of the Liver, out of whose grape-stone-like Glandules they imbibe the Choler there separated from the Bloud; even as was said before of the Capillaries of the Cava, that they received the Bloud it self imported by the Porta, in like manner, without any inoscula∣tions.

The use of both these Vessels may sufficiently be learned by what has already been said of them.* 1.12 As also may the use of the Bile it self from what we quoted above out of Diemerbroeck, when we were treating of the action of the Liver, chap. 12. We will only further note two things.

First, that sometimes the Ductus communis is very irregularly inserted. For in some it is knit to the bottom of the Stomach, and then the party vomiteth Choler, and is termed 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉; and sometimes it is inserted into the lower end of the Jejunum, and then bilious dejections follow: and such a one is termed 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉.

A second thing is concerning the colour of the Bile; that though for the most part, (in a health∣full state) it be yellow, yet preternaturally and in a morbous state it is often of several other co∣lours, as pale-coloured, eruginous, porraceous, vitelline, reddish and blackish. And when it thus degenerates and corrupts, it is the cause of most violent and acute Diseases; as the Cholera morbus, Dysentery, Colick, &c.

Notes

• * 1.1

  Its name, and descri∣ption.
• * 1.2

  Its bigness.
• * 1.3

  Its c••n∣nexion.
• * 1.4

  Its mem∣branes.
• * 1.5

  The fibres of the pro∣per mem∣brane.
• * 1.6

  The parts of it.
• * 1.7

  How the choler is brought in∣to it.
• * 1.8

  Its valves.
• * 1.9

  Its vessels.
• * 1.10

  Of the stones in it.
• * 1.11

  Porus bi∣larius.
• * 1.12

  Their use.