The liver may present several morbid phenomena, which, in a dissection instituted for the purpose of discovering the cause of death, ought not to be overlooked. It may also be found ruptured, an occurrence which may take place where little or no external injury can be perceived, as from a sudden fall, or from the application of strong pressure applied to the upper part of the abdomen, such as might be occasioned by the passage of a heavy carriage over the body. _Morgagni_ relates several instances of ruptured liver, by mechanical causes, without any considerable injury of the integuments. In the _Medical Transactions of the College of Physicians_,[35] a very interesting case is communicated by _Dr. George Pearson_, of a young man who fell with his _right hypogastrium_ and _epigastrium_, upon the edge of a pail, which he held in his hand, as the sixth step of a ladder, upon which he was standing, suddenly broke; his death happened ten hours after the accident, and upon dissection, the right lobe of the liver was discovered divided, in an oblique direction, through its whole substance, from its extremity on the right side, to the border of the left lobe; the two portions being only connected by the _vena cava_, and the trunks of the _venæ cavæ hepaticæ_.
The author has been informed by _Dr. Harrison_ that, while at _Mantua_, he saw a man who had received a kick on the right _hypochondrium_ from a horse that he was shoeing; he did not complain of much pain at the time, but exhibited an anxious countenance, and was attacked with _coffee-ground_ vomiting. He died on the following day, and upon opening the abdomen the liver was found ruptured, and the peritoneum inflamed.[36]
The spleen may be brought into view for our examination by drawing the stomach towards the right side, when the one viscus will follow the other. This organ, like the liver, may be ruptured by violence; of which we have already cited an instance[37].
The _pancreas_ is to be seen by tearing through the great omentum, between the large curve of the stomach, and the arch of the colon. The anatomist will proceed to the examination of the remaining structures in the abdomen with a facility that renders any farther directions unnecessary; we have only to repeat that in cases of forensic interest, the inspection cannot be too minute. The appearance of the kidneys, although not generally an object of dissection, ought to be noticed, as it is frequently connected with the exhibition of poisons; like the other solid viscera too, the kidneys may be ruptured by external violence, and several instances are recorded of sudden death having been thus occasioned.