Liver An Introduction
NATIONAL JOURNAL OF HOMOEOPATHY 1993 May / Jun Vol II No 3.
Dr Asrani C H.

Liver is the largest organ in the body with a weight of approximately 1200-1500 gms in an average adult. It is sheltered by the ribs in the right upper quadrant of the abdomen. Its upper border lies approximately 1 cm below the right nipple. It is pyramidal in shape. The lower border roughly corresponds with the right subcostal margin.

Liver has a good blood supply. Portal vein brings venous blood from the GI tract and spleen thus bringing all the nutrients absorbed in the intestines. The hepatic artery from the coeliac axis supplies the liver with arterial blood. These vessels enter the liver through a fissure called Porta Hepatis.

Following are the various important functions of the liver which are essential for the smooth functioning of the body.

1. Various energy providing processes take place in the liver. Glycogen is synthesized and stored in the liver. Neoglucogenesis also takes place in the liver.
2. Haem-synthesis also occurs in the liver.
3. Specific hepatic proteins especially albumin and proteins used in blood coagulation are synthesized here.
4. Glucose-6-phosphates which is required for maintaining blood glucose levels, is synthesized here.
5. Detoxification of many drugs and foreign compounds takes place here.
6. Bile acids are formed and conjugated with amino acids.
7. Kupper cells are responsible for phagocytosis.
8. Secretion of Bile. The functions of bile are
   1. Assist in absorption of triglycerides together with calcium, cholesterol and fat soluble vitamins.
   2. It is the main route for excretion of bilirubin, cholesterol, steroids, thyroid and other hormones.
   3. It is also the main route of excretion of several drugs and poisons.
   4. Bile salts activate intestinal and pancreatic enzymes.

1. Viral hepatitis (Infective hepatitis) Type A Virus.
2. Amoebic hepatitis and abscess.
3. Alcoholic hepatitis
4. Cirrhosis of the liver due to Alcohol
   • due to Malnutritional
   • Post necrotic
   • Post congestive
5. Viral hepatitis B
6. Drug induced hepatitis most commonly following Antitubercular drugs.
7. Jaundice - haemolytic
   • obstructive
   • infective

1. Malaria.
2. Typhoid fever.
3. Hepatic amoebiasis
4. Kala Azar
5. Hepatitis due to various viruses.
6. Congestive as in CCF, Constrictive pericarditis.
7. Early stages of cirrhosis.
8. Storage disorders -rare
9. Hepatoma.

1. Serum Bilirubin: Normal Value- 0.8-1.2 mg / 100ml. This rises in all types of jaundice. Direct or conjugated is always more than Indirect or unconjugated bilirubin. A reversal of this indicates Haemolytic jaundice.
2. SGOT (Serum Glutamic Oxaloacetic Transaminase) -Present in heart, liver and muscles. Its level increases when the tissues are acutely destroyed. Very high values are found with hepatocellular necrosis or Myocardial infarction. This is more relied upon Acute Myocardial Infarction.
3. SGPT (serum Glutamic Pyruvate Transaminase) - This is more specific of liver damage than SGOT.
4. Serum Alkaline phosphatase-In normal individuals levels are three times more in children than adults. A three fold increase suggests Obstructive jaundice.
5. GGTP - is a very sensitive marker and in Alcoholic liver damage it is the first enzyme to rise.
6. Serum Proteins - Changes in serum protein levels are slow and do not indicate acute liver damage. In chronic liver diseases eg Cirrhosis there is a fall in serum Albumin levels and a rise in serum Globulin levels. Thus Albumin Globulin Ratio should be measured as the total serum proteins may be normal. In severe prolonged Viral Hepatitis and Cirrhosis, Serum Albumin levels closely relate to the clinical state and are helpful prognostically and following the treatment. It is not much of a diagnostic significance.
7. Serum Cholesterol - levels rise in obstructive jaundice. Lower levels in Malnutrition.
8. Serum Triglycerides levels rise in obstructive jaundice.
9. Prothrombin time- Lengthened in viral hepatitis and Hepatocellular failure.

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