From the earliest times of recorded history, the liver has enjoyed special attention and fascination. In ancient Mesopotamia, the cradle of civilization, sorcerers and physicians would perform divination rituals in order to discover the sin committed by a person, which rendered them ill. This was often accomplished by hepatascopy in which the liver of a sacrified animal, such as a sheep, would be carefully examined in an effort to determine the tribute demanded by the gods for the transgression. The underlying idea was that the liver was the collecting point of blood and therefore the seat of life (1). By carefully examining its topical anatomy, the intentions of the gods could be discerned. According to the world’s oldest medical record, a Sumerian clay tablet dating from 2150 B.C., the responsibilities of the treating physicians were to wash wounds, make poultices, and apply bandages; the physicians in ancient Babylon may have been the first to be regulated by law because a description in the Hammurabic code describing their pay scale and obligations stated, “if a physician performs a major operation on a lord… and has caused the lord’s death… they shall cut off his hand” (2). Such penalties were derived from divination rituals using hepatoscopy. It is little wonder that the liver has enjoyed a high place of preeminence down through the centuries. Even today, it is associated with continuing mystery. How does it regenerate itself when large portions are resected? When many other organs are expendable why are its functions so crucial that life itself depends on its health? While many of its mysteries have been unraveled, the liver continues to be an unusual organ demanding great respect. This chapter attempts to explain its complex anatomy and physiology and why it is so important if homeostasis is to be insured for the entire human organism.
|Title of host publication||Modern Surgical Care|
|Subtitle of host publication||Physiologic Foundations and Clinical Applications, Third Edition|
|Number of pages||16|
|State||Published - 1 Jan 2006|