A case of primary melanotic sarcoma of the liver / by Sheridan Delépine.

  • Delépine, Sheridan, 1855-1921.
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: A case of primary melanotic sarcoma of the liver / by Sheridan Delépine. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    formation of melanin independently of the presence of haemoglobin. I have shown elsewhere that melanin is constantly manufactured in the epithelia exposed to light and other stimuli, and that some colourless or pale soluble compound allied to it must pass from the skin into the deeper parts of the body, and by elaboration in hsemo- poietic organs be one of the elements in the production of haemo- globin ('Proceedings Physiological Society,' December, 1890; ' Journal of Phys.,' vol. xii). I have also elsewhere shown that iron is normally stored in the liver, and leaves that organ in some soluble form by the hepatic veins; and I have surmised that the iron thus saved from the products of degeneration of decayed red blood- corpuscles was used again in the production of fresh haemoglobin (< Practitioner,' August, 1890). It is easy to understand how a dis- turbance or want of equilibrium between these two functions would lead on the one hand to anaemia, and on the other to melanosis. Clinical remarks— From a clinical point of view the case is of interest in showing the almost absolute balance existing between the loss of weight by the body generally and the increase of a single organ. The weight of the body generally increased only by 6^ lbs. during four years, and therefore can be said to have remained nearly stationary. The weight of the liver increased by at least 13 lbs. It is important to keep in mind that the increase of weight during the first three and a quarter years was only 3£ lbs., i. e. about 1 lb. per annum. During three months of his last year of life the increase was 3 lbs., i. e. at the rate of nearly 12 lbs. in the year. Such a rapid increase of weight at a time when the patient was getting worse is extremely remarkable. It is all the more signifi- cant that it is soon after this rapid increase had been noticed that the large size of the liver began to attract attention, and that was only a fortnight before death. So that whilst the body (the liver being excluded) was losing 6| lbs., the liver was gaining the same number of pounds and 6| more. There is, however, one fact which is of interest in relation to that part of the question, and it is this : the liver, being on the road taken by a large portion of the food absorbed by the intestine, might have diverted part of the food which usually is only stored up in its substance, or simply passes through it. This is rendered probable by the general increase of weight, increase which is evidently due to the growth of the parasitic tissue. Tins points