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In the 4th century B.C. Plato liver nutritive soul 11th century A.D. Anglo-Saxon chronicle notes meat intolerance in cirrhosis 1600 B.C. Ebers Papyrus hints relationship of ascites and liver disease 5th century B.C. Hippocrates theory of disease based on proportion of black bile to yellow bile describes cirrhosis epidemic jaundice jaundice with delirium 4th century B.C. Plato liver nutritive soul Erasistratus of Alexandria association of ascites with cirrhosis 1st century A.D. Rufus icterus classification with fevers with bile duct obstruction or with abscess 5th century A.D. Caelius Aurelianus notes urine discoloration with cirrhosis 11th century A.D. Anglo-Saxon chronicle notes meat intolerance in cirrhosis 1400-1500 Metlinger jaundice of newborn 1600-1700 Shakespeare and hepatic coma Sir Andrew Aguecheck goes into hepatic coma due to meat intolerance 1700-1800 Boerhaave links jaundice of hepatitis to bile duct obstruction Morgagni pathologic studies of jaundice cancer jaundice Baillie alcoholism and cirrhosis 1800-1900 Laennec proposes the term cirrhosis Bremser describes echinococcosis Griffin modern account of hepatic coma Bright clinico-pathologic entity of pyogenic liver abscess Becquerel cardiac cirrhosis Rokitansky names acute yellow atrophy Abercombie describes ruptured liver in pregnancy Van Deen describes chronic perihepatitis Budd describes Budd- Chiari Syndrome Flint describes renal faiure and cirrhosis Troisier describes hemochromatosis Orth describes kernicterus coined by Schmorl Hanot describes the entity of primary biliary cirrhosis Sabourin notes association of cirrhosis with hepatocellular carcinoma Lurman serum hepatitis Westphal depicts entity Wilson’s disease Hanot and Schachmann coin term “bronze diabetes” Gilbert introduces term “portal hypertension” 1900-2000 Gilbert and Lereboullet describe Gilbert’s disease Kayser and later Fleischer describe corneal rings in Wilson’s disease Mallory describes alcoholic hepattis Yamagawa two major types of hepatocellular carcinoma Wilson describes Wilson’s syndrome Cockayne describes epidemic jaundice Helwig and Schutz coin term “hepatorenal syndrome” Waldenstrom describes chronic active hepatitis Ahrens coin term primary biliary cirrhosis Dubin and Johnson describe Dubin-Johnson syndrome Conn describes spontaneus bacterial peritonitis Klatskin describes Klatskin tumor Prine describe a third viral

3000-2000 BC – Babylonians divine sheeps’ livers; the belief that the liver is the seat of the soul is probably due to its size, warmth, and enrichment with blood and therefore the repository of life. They recognized and mentioned the gall bladder, cytic duct, and bile ducts

Table of events

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3000-2000 BC – Babylonians divine the sheep’s liver due to the belief that the liver was the seat of the soul; this was probably because of its size, warmth, and enrichment with
blood, making it the repository of life.

Ancient Greeks and Romans saw the liver as the seat of emotion and the seat of life and hence its name.
Mythologic figure Prometheus

500-400 BC – Hippocrates: The liver supplies the brain with blood.

Diogenes: There is double circulation, with the liver on one side.

400-300 BC – Etruscans’ hepatoscopy.

Plato: The liver is the nutritive soul.

Socrates: The liver is sweet.

Heropilus makes the first accurate description of the human liver.

Erastistratus: The liver is a capillary bed.

100-0 BC- Celsus describes the liver as four-lobed.

0-100 AD – Rufus describes the liver as five-lobed.

100-200A.D. – Aretaeus of Cappadocia understood that the portal vein drained the stomach and intestines to the liver and then to the inferior vena cava.

100-200 AD – Galen: The liver as the dominant organ

1400-1500 AD – Da Vinci: The heart and not liver is the origin of circulation

1500-1600 – Vesalius misconceives the portal circulation.

1600 – 1700 – Shakespeare refers to the liver in “Love’s Labors Lost.”

Aselli rediscovers mesenteric lacteals.

Harvey formulates correct theory about general circulation of the blood.

Waleus describes the liver’s capsule.

Vesling reports a bifurcation of a portal vein.

Bartholin dethrones the liver.

“Glisson contributes to understanding of the anatomy of the liver and liver capsule.
In ancient times the liver was thought to be the seat of the soul. The Roman physician Galen (c.AD 130-200) gave it the central role in the functioning of the human body – the organ which took food from the gut and transformed it into blood. These teachings were not questioned until the 17th century when the English physician Francis Glisson, published the first book devoted exclusively to the anatomy of the liver. First published in 1654 it was also the first book printed in England to give a detailed account, based on original research, of a single organ. Glisson used advanced methods such as the injection of coloured liquids and casts which enabled him to illustrate the vessels of the liver. It gives the first accurate description of the capsule of the liver (Glisson’s capsule), its blood supply, and the sphincter of the bile duct (Glisson’s sphincter).”

Wepfer describes lobular pattern of a pig’s liver.

Malpighi: The liver is a conglomerate gland

1700-1800 – Haller: Human hepatic lobation

1800-1900 – Hernan: The hepatic lobule

Brissaud/Sabourin: The portal lobule

 

Historical perspectives

In the 4th century B.C. Plato liver nutritive soul 11th century A.D. Anglo-Saxon chronicle notes meat intolerance in cirrhosis 1600 B.C. Ebers Papyrus hints relationship of ascites and liver disease 5th century B.C. Hippocrates theory of disease based on proportion of black bile to yellow bile describes cirrhosis epidemic jaundice jaundice with delirium 4th century B.C. Plato liver nutritive soul Erasistratus of Alexandria association of ascites with cirrhosis 1st century A.D. Rufus icterus classification with fevers with bile duct obstruction or with abscess 5th century A.D. Caelius Aurelianus notes urine discoloration with cirrhosis 11th century A.D. Anglo-Saxon chronicle notes meat intolerance in cirrhosis 1400-1500 Metlinger jaundice of newborn 1600-1700 Shakespeare and hepatic coma Sir Andrew Aguecheck goes into hepatic coma due to meat intolerance 1700-1800 Boerhaave links jaundice of hepatitis to bile duct obstruction Morgagni pathologic studies of jaundice cancer jaundice Baillie alcoholism and cirrhosis 1800-1900 Laennec proposes the term cirrhosis Bremser describes echinococcosis Griffin modern account of hepatic coma Bright clinico-pathologic entity of pyogenic liver abscess Becquerel cardiac cirrhosis Rokitansky names acute yellow atrophy Abercombie describes ruptured liver in pregnancy Van Deen describes chronic perihepatitis Budd describes Budd- Chiari Syndrome Flint describes renal faiure and cirrhosis Troisier describes hemochromatosis Orth describes kernicterus coined by Schmorl Hanot describes the entity of primary biliary cirrhosis Sabourin notes association of cirrhosis with hepatocellular carcinoma Lurman serum hepatitis Westphal depicts entity Wilson’s disease Hanot and Schachmann coin term “bronze diabetes” Gilbert introduces term “portal hypertension” 1900-2000 Gilbert and Lereboullet describe Gilbert’s disease Kayser and later Fleischer describe corneal rings in Wilson’s disease Mallory describes alcoholic hepattis Yamagawa two major types of hepatocellular carcinoma Wilson describes Wilson’s syndrome Cockayne describes epidemic jaundice Helwig and Schutz coin term “hepatorenal syndrome” Waldenstrom describes chronic active hepatitis Ahrens coin term primary biliary cirrhosis Dubin and Johnson describe Dubin-Johnson syndrome Conn describes spontaneus bacterial peritonitis Klatskin describes Klatskin tumor Prine describe a third viral

3000-2000 BC – Babylonians divine sheeps’ livers; the belief that the liver is the seat of the soul is probably due to its size, warmth, and enrichment with blood and therefore the repository of life. They recognized and mentioned the gall bladder, cytic duct, and bile ducts.

Etruscan  Culture and the Gallbladder
Piacenza Bronze Liver Model, Piacenza Museo Civico, Hellenistic Period, and Map Reference

Reference

http://traumwerk.stanford.edu/archaeolog/2007/09/reading_livers_through_reading_1.html

 

Babylonian  Culture and the Gallbladder
Sheep?s liver in clay. 14.6 cm across. Old Babylonian, circa 1900-1600 BC. ?Provenance: likely Sippar in modern southern Iraq. British Museum, London, Western Asia Collection # ME 92668

Reference

http://traumwerk.stanford.edu/archaeolog/2007/09/reading_livers_through_reading_1.html

Greek Culture and the Gallbladder
27390b01 Hippocrates Gallbladder Courtesy Ashley DAvidoff MD copyright 2008

 

 

Greek Culture and the Gallbladder
Etruscan Bronze Mirror of Chalchas the Seer Reading a Liver (Vatican: Gregorian Museum, Rome, cat # 12240)

Reference http://traumwerk.stanford.edu/archaeolog/2007/09/reading_livers_through_reading_1.html

 

Early Greeks believed in four humors in the human body: phlegm, blood, bile, and water. When the humoral blend is perfect, man is in perfect health; when balance is upset and a certain humor is drained from the body, disease results. The concept of ?black bile? came from the Greek observations; there was an assumption that ordinary yellow bile, through corruption, could become black, and that this black bile could cause disease–notably the “black bile disease,” or “melancholy.”

The four humors phlegmatic, sanguine, melancholic, and choleric were respectively produced by the lung, liver, gallbladder and spleen.  These organs each produced a fluid: the lungs produced phlegm, while the liver produced blood, the gallbladder made black bile and the spleen was responsible for yellow bile.  These biological fluids each reflected an element with the lung representing water, the liver air, the gallbladder earth and the spleen fire.  Additionally each of the organs had special qualities.  The lungs were considered cold and moist, the liver hot and moist, the gallbladder cold and dry, and the spleen hot and dry.  The humors of each organ were thought to produce vapors which would ascend to the brain and would affect the person?s personality.  Thus the lungs were thought to produce a vapor that would manifest as a sluggish, dull, timid and fearful character.  The liver personality was happy, easy going, generous and optimistic. The gallbladder type was introspective, subject to gluttony, but also sentimental.  The splenic personality was ambitious, but short tempered, vengeful, and given to violence.  Thus the  lung reflecting the element water produced phlegm which in turn represented a cold and moist character that created a personality which was slow timid and dull.

Galen’s Concept of the Organs and their Faculties
Heat plays a central role part in the theory of Galen. The three ?faculties? of the body are the nutritive, vital and logical faculties. The nutritive faculty is related to the stomach which “cooks” the food and converts it into chyle. The chyle is transported to the liver by the portal vein. In the liver further heat converts the food into blood and adds natural spirit. Some of the blood is transported via the veins to the heart where more heat is added to create vital spirit. The blood becomes thinner is distributed to the body by the arteries giving warmth and enables growth. The vital spirit is measured through the pulse. The brain adds psychic pneuma, which provides the rational and logical faculty in the form of thought will and choice. These are distributed to the body via the nerves. The logical faculty reigns supreme and is followed in orderof importance by the vital and nutrtive faculties. The transport systems of the body include the nerves which transmit the logical faculty, the arteries which transport the vital spirit, and the veins which transport the blood with nutritive faculty from the liver. Galen faculties of the body nutrition portal vein stomach liver vein heart vital faculty pneuma lungs brain logical faculty animal spirits Davidoff art Copyright 2008 13169c18b01.8s
Vesalius
13237 abdomen small bowel liver gallbladder anatomy Vesalius historical drawing DB

350 B.C. – Diocles of Carystos, Greece, writes the first book on anatomy; it describe the gallbladder as well as ascites, linking it with the liver and spleen.
1514-1564 B.C. – Andreas Vesalius writes a series of texts published as seven books under the title “Fabrica”; Book Five is on the abdominal viscera, and it discusses the vermiform appendix cecum. The gallbladder is extensively discussed, but there is little mention of the stomach, liver, or spleen.

da Vinci and the Gallbladder
44410 liver gallbladder portal vein IVC hepatic veins applied biology celiac axis hepatic artery historical art da Vinci


Gallbladder edema secondary to liver congestion
gallbladder wall fx edema dx CHF liver heart cardiac dx CHF liver CHF acute cardiac failure CTscan
Courtesy Ashley Davidoff MD
00425

References

Stanford  Outstanding reference