The liver is movable within certain narrow limits. It moves with respiration. On inspiration, it moves down with the diaphragm to a little below the right nipple line. The ligaments do not give the liver much support because they lie relaxed, but it does get its main support from the connective tissue which unites the liver to the diaphragm, the hepatic veins which join the vena cava and also by the intra-abdominal pressure resulting from the tonic contraction of the abdominal muscles. Also when the abdominal tension is normal, the intestines are driven up, and become a bed for the liver. [Illustration: FIG. 25—Excretory apparatus of the liver. (Poirier and Charpy)] The most important function is the secretion of the bile; it is also the excretor of deleterious matter and impurities. It also effects important changes of the blood in its passage through it, for the portal circulation. The excretory apparatus of the liver consists (a) of the hepatic duct, (b) the gall bladder, (c) cystic duct, (d) the common bile duct. The hepatic duct is formed by two main trunks nearly of equal size which issue from the liver, one from the right and one from the left lobe. The hepatic duct passes downward and to the right from one to two inches where it is joined at an acute angle with the cystic duct. =The Gall Bladder.=—The bladder is a reservoir for the bile. It is a conical or pear-shaped sack, lying on the under surface of the right lobe of the liver. It is about four inches in length, one inch in depth and holds from eight to ten drams. The cystic duct is about an inch and a half in length, and passes obliquely downward to the left from the neck of the gall bladder, and joins the hepatic duct. The common bile duct (ductus communis choledochous) is the common excretory duct of the liver and the gall bladder, and is formed by the union of the cystic and hepatic ducts. It descends to the middle portion of the duodenum, where it unites with the pancreatic duct, the two passing obliquely through the wall of the descending portion of the duodenum. The tissues of the liver are nourished by the blood from the hepatic arteries. =The Pancreas.=—The pancreas (the sweet bread) is a gland similar in structure to the salivary glands; is about seven inches long, of a grayish white color; its weight varies from two to six ounces. It is situated behind the stomach, and it secretes the pancreatic juice. It extends to the right in a part of the epigastric space. The tail lies above the left kidney, and is in contact with the lower end of the spleen and in the left hypochondriac region; the body lies behind the stomach and transverse colon and in front of the great aorta, portal vein and inferior vena cava. The arteries nourishing it are the large and small pancreatic, which are branches of the splenic artery.