The lymphatic vessels of the liver observed by Frederik Ruysch
The Dutch physician and anatomist Frederik Ruysch [1638–1731] was back in the 17th century, one of the first to discover the lymphatic vessels and associated lymph nodes. He exposed the inguinal lymph nodes during dissection of a human cadaver; however, most of his observations were based on anatomical dissections of living animals (1). He had a wide reputation for his exceptional anatomical dissection skills.
He performed an anatomical dissection of a horse three hours after the animal had eaten, and noted ‘white vessels’ with a milky content in the mesentery of the animal. He prepared these lymphatic vessels and after tying off on two sides, he filled a vessel with air using a fine syringe. He observed ‘crescent-shaped’ valves in the lymphatic vessels and concluded that the flow of lymph was directed into one direction (2).
He went on to investigate the horse’s liver and observed superficial lymphatic vessels in Glisson’s capsule converging to the hilum of the liver. As an anatomist, Ruysch described his observations in great detail. He published a beautiful engraving of the lymphatic vessels of the horse’s liver showing the bulging, luminal valves suggesting centripetal flow of the lymph in Glisson’s capsule, eventually draining into the subhepatic lymph nodes and the nodes along the hepatoduodenal ligament (3) (Figure 1).
Lacking the advanced microscopic techniques we have now, Ruysch could not further elucidate the anatomy and internal pathways of the lymphatic system of the liver. At that time, the liver was considered the organ in which blood was produced, as suggested by the dark-red color of the organ and the knowledge that the liver could massively bleed. He had no idea of the functional constituents of the liver, other than that waste products were collected in the liver and excreted into the bile. Although we have now taken enormous steps in understanding the liver and its portal and arterial microvasculature, the anatomy and function of the lymphatic system of the liver have remained largely undetermined, almost three centuries after Ruysch’s early observations.
Acknowledgments
The author wishes to thank Frank IJpma for his valuable contribution.
Funding: None.
Footnote
Provenance and Peer Review: This article was commissioned by the editorial office, HepatoBiliary Surgery and Nutrition. The article did not undergo external peer review.
Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-24-536/coif). T.M.v.G. serves as an unpaid Deputy Editor-in-Chief of HepatoBiliary Surgery and Nutrition. The author has no other conflicts of interest to declare.
Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
References
- Ijpma FF, van Gulik TM. "Anatomy lesson of Frederik Ruysch" of 1670: a tribute to Ruysch's contributions to lymphatic anatomy. World J Surg 2013;37:1996-2001. [Crossref] [PubMed]
- IJpma FFA, van Gulik TM. ‘Amsterdam’s Anatomy Lessons Dissected’. AUP, Amsterdam; 2024. ISBN 978 90 4856 828 4.
- Ruysch F. Alle de ontleed-, genees-, en heelkundige werken van Frederik Ruysch. Janssoons van Waesbergen, Amsterdam Collection Library University of Amsterdam; 1744.
