HEPATIC AFFECTION, catenating with afo fection of the stomach, and produced by hot climates or hard drinking.
We have already sufficiently comment ed upon the general nature of the bile, and the importance of its due and wealthy floe towards the proper action of the stomach, and the whole of the intestinal canal. Now it is clear, that if the organ which secretes this important fluid be perpetually irritated by a stimulus of any kind whatever, it will first become inflamed, and suppurate, if the inflamma tion be very great and progressive ; and secondly, it will become wholly exhaust ed and torpid, if the stimulus ce not suf ficient to produce inflammation.
The stimuli of hot climates and of hard drinking, especially when the beverage consists largely of alcohol, have both a tendency to produce each of these ef fects, though not in an equal degree ; and consequently not merely to injure the liver itself, but to derange the entire process and economy of digestion.
In general, those who are affected by a diseased state of the liver in warm cli mates return to their native homes before inflammation sufficient to excite suppu ration has taken place ; and hence in our own country we seldom meet with cases of this kind; but if the same persons do not return home in lime, or if they be actually prevented from returning at all, suppuration will be a frequent conse quence of the disease they are labouring under, and it is therefore a result which is by no means ucommon in the East and 'West Indies.
Commonly, as the case appears to us, on the arrival of the patient in Europe, the morbid excitement of the liver has only produced an enlargement of its pa renchyma by the effusion of coagulable lymph ; which is often re-absorbed by a recovery of healthy action in the lympha tics of the affected viscus, and especially by gently stimulating them through the medium of mercury. In the meanwhile, however, the stomach and the whole of the digestive economy suffers severely, and much attention is necessary to the nature and regulation of the diet.
The excitement produced by hard drinking has a worse tendency, and is often succeeded by a worse result to the stomach, liver, and indeed all the chyly poietic viscera, than that produced by'' hot climates. For, though in tire former
case we have seldom morbid action enough to produce suppuration, we have • enough to excite scirrhus, in conjunction with torpidity, and consequently to resi der the organs almost incapable of recal to a healthy and harmonious state by any • kind of regimen, or plan of medicine whatever. While, at the same time, the villous membrane of the stomach, from perpetual exposure to the acrimony of alcohol, becomes abraded of the mouths of its secerning vessels, and rendered often polished and glabrous throughout , its whole surface, like a sheet of glass; whence the stomach is . just as incapable ofsecreting gastric juice, as the liver is of secreting bile.
The symptoms chiefly indicatory of an affection of the liver, from a long resi dence in lint climates, are costiveness, often alternating with diarrhcea,, or dy- o sentery ; strong spasmodic pains about the epigastr•um, and hypochondria; fla tulence, and at times cardialgia. There is also a general languor and depression, • altogether intolerable and insuperable-to the patient. If he indulge in activity, he sinks into a state of increasing debility, and if he attempt any moderate exertion lie is overcome by fatigne,or sutlers from " cold or from some new symptoms, the consequences of accidentally increased action ; and sinless some effectual, but moderate and permanent,.means of re lief be afforded, he dies of some symp tomatic disease which ensues, or sinks • exhausted by the primary affection of the stomach and other viscera concerned in digestion. Such are the most striking features of disease originating from this state of the abdominal viscera, when it is severe and permanent. In the more common attacks, a great number of symp toms are very troublesome : nausea, car dialgia, eructation, faintness, sense of weight, and oppression in the epigiss tric region, which is tender to the touch, and pain between the shoulders. In al- • most every case, the appetite is exceed ingly fastidious ; if food be not taken, artulency and sense of languor increase, ann the spasm becomes severe ; and after eating, all the symptoms of dyspep sia occur, and the pain very often is ag gravated.