------------------------------------------------------------------------ CHAPTER XIII. THE DESTRUCTION OF TOXIC PRODUCTS BY THE LIVER AND THE IMPROVEMENT OF ITS PROTECTIVE FUNCTIONS. THE liver is one of the most important of our organs. As Professor Hemmeter, of Baltimore, says, “The liver is an organ secondary in importance only to the heart. Living things can exist without stomachs. They can live for forty days without eating, but mammalia can only live a few days, sometimes not twenty-four hours, without a liver.” The importance of the functions of the liver is illustrated in this picturesque remark of Dr. Rovighi[172]: “Like unto Minos in Dante, the liver tests the conscience of those that want to enter, and knows their sins.” Footnote 172: Quoted after Professor Hemmeter. Address to Sixty-first Annual Meeting of the Ohio State Medical Association, May 9-11, Canton, Ohio. We introduce into our stomach and intestines a number of poisonous substances which, if injected into our blood, would kill us, or at least, cause grave intoxication. Yet because they are taken by the mouth they are harmless, and the reason for this strange phenomenon is that they must pass through the liver, being brought to this organ from the intestines through the portal vein, and are there destroyed. This is illustrated in the case of the Indian snake charmers, who acquire immunity against snake-bites after having first sucked the poisonous fang of the snakes and absorbed the toxin via the intestine. They thereby gradually accustom their body to this terrible poison, which, taken in this manner, is far less harmful, since it passes through the liver. That the liver destroys various poisons was first shown by our esteemed friend, Prof. Paul Heger,[173] of Brussels University, who demonstrated by experiments that nicotin added to blood soon disappeared after it had been passed through the liver artificially. After this remarkable discovery other authorities have found reason to state that the liver also destroys other poisons, in particular alkaloids: strychnine and atropine (Professor Roger[174]), hyoscyamine (Heger and Buys[175]), quinine, morphia, curare (Lussana). According to Schiff, and Lautenbach, alkaloids undergo a chemical change under the influence of the liver. As Slowzoff[176] found, the liver also protects us against poisons such as arsenic; therefore we can understand why persons suffering from hepatic disease cannot tolerate arsenic. This should be taken into consideration when we are treating patients with cacodylates, or with atoxyl. Footnote 173: Thèse de Bruxelles, 1873; Journal méd. de Bruxelles, 1877; C. R. de l’Académie des Sciences, May, 1880. Footnote 174: Thèse de Paris, 1887. Footnote 175: Quoted from Hanot, Archives Gén. de Médecine, II, 895. Footnote 176: Slowzoff: Beitr. zur chem. Physiologie u. Path., p. 281, 1901.