Enlargement of the liver occurs, most frequently, as the result of morbid changes. There is more or less enlargement in all cases of congestion and inflammation. Enlargements of this class, however, are of a temporary character, lasting but for a short time. The more serious cases of enlargement are more or less permanent. Enlargement of the liver is sometimes accompanied by pain, as when it is the result of congestion, inflammation, abscess, cancer, or catarrh of the bile-ducts. In some cases there is no pain, as in fatty and waxy liver, hydatids and hypertrophy of the organ. The symptoms which accompany the disease differ according to the cause of the enlargement and the particular form of the disease present. The abnormal size of the organ may be easily discovered by palpitation of the abdomen, as the patient lies on his back with his knees drawn up so as to relieve the abdominal walls. In health, the lower border of the liver reaches only to the lower edge of the ribs on the right side, but in disease it may be extended so as to fill up a considerable proportion of the abdomen. Fig. 288 represents the normal size and position of the liver.

Fig. 288. Shows the Natural Size and Position of Liver.

Fig. 288. Shows the Natural Size and Position of Liver.

Fig. 289 shows the size of the liver in a case which we have under treatment at the time of this writing. It will be observed that the organ is increased to several times its natural size.

Fig. 289. Greatly enlarged Liver.

Fig. 289. Greatly enlarged Liver.