Gall-stones and diseases of the bile-ducts . ingwith diseases of the bile-ducts to consider the effectsof those forms of pancreatic disease which directlyaffect, and indeed, often implicate, the main con-duits of the liver, as well as those affections of thecommon bile-duct which exercise a maliffn influence o over the pancreas. It is curious that of these two important glandsso largely concerned in digestion, one, the liver,should be the largest and most conspicuous organ inany mammal, and the other, the pancreas, may bedescribed as one of the least obtrusive and appa-rently insignificant org
Gall-stones and diseases of the bile-ducts . ingwith diseases of the bile-ducts to consider the effectsof those forms of pancreatic disease which directlyaffect, and indeed, often implicate, the main con-duits of the liver, as well as those affections of thecommon bile-duct which exercise a maliffn influence o over the pancreas. It is curious that of these two important glandsso largely concerned in digestion, one, the liver,should be the largest and most conspicuous organ inany mammal, and the other, the pancreas, may bedescribed as one of the least obtrusive and appa-rently insignificant organ in the mammalian economy,yet the complete abrogation of its functions is assurely fatal as renal bankruptcy. When the inti-mate relationship of the terminal segment of the 134 DISEASES OF THE BILE-DUCTS common bile-duct and of tlie pancreatic duct areconsidered—for they both open independently intoan ampulla with a diameter of only 4 mm., andtheir secretions issue into the duodenum througha common orifice less than 2 mm. across—it is. Fig. 42.—A drawing showing the intimate relations of thepancreas, duodenum, and common bile-ducts (Sobotta). surprising that they are not more frequently im-plicated in a common disorder than is actually thecase. The manner in which disease may attack theterminal segment of the common bile-duct and notimplicate the pancreatic duct is illustrated by some DISEASES OF THE PANCREAS 135 specimens of congenital obliteration of the ducts(Chap. Ill), in which more than half the commonbile-duct has undergone antenatal obliteration, andpersists as a mere thread, but the terminal orifice ofthe pancreatic duct may be pervious and the papillaand ampulla normal. The pancreatic duct, in common with the mainduct of all compound glands, is liable to be infectedwith micro-organisms of varying degrees of virulence,and the changes in the glandular tissue of thepancreas in consequence of such infections is knownas pancreatitis, with the usual qualifications o
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