Those who, during their residence in a hot climate, have been attacked by acute inflammation of the liver, not terminat ing in suppuration, are frequently found, on their return to Europe, as we have already observed, to have the liver en larged from the deposition of coagulable lymph in the progress of the inflamma tion, and in its termination by resolu tion: in the same manner as the testi cle, and particularly of the epididymis, which remains for a long time enlarged after the inflammation called hernia hu moralis : it is seldom, however, that these symptoms will not yield to a judi cious and persevering mode of medical practice.
In affections of the stomach and other • chylopoietic organs from hard drinking, the chief of the same symptoms will be found to occur : but those peculiarly at tendant upon this last disease, perpetual loss of appetite, nausea, and vomiting, when the stomach is empty ; an almost constant pain at the pit of the stomach ; a general tremulation of the muscles, and especially those of the hands and arms, so that nothing can be held steady; vertigo, and frequent fainting fits.
In the case of enlarged liver, from the deposit or accumulation of coagulable lymph, mercury should be administered so freely and reiteratedly, as to produce immediate and permanent action on the liver, and rather by inunction on the ab domen than by the mouth ; or perhaps by both at the same time. Yet the exhi bition of mercury in large quantities, and so as to excite ptyalism, has of late years become too indiscriminate; and excepting in the individual case now alluded to, its admission in this unrestrained manner will be generally doubtful, and often un questionably injurious. In all other ca ses, when its use is at all indicated (and it is seldom that it is not indicated) it should be administered in small doses, seldom exceeding the quantity of half a grain of calomel once or twice a day : and the plan thus begun should be persever ed in for w
Aperient medicines are almost always necessary, from the great irregularity of the bowels, and generally an habitual propensity to costiveness. Dr. Stone has lately opposed the use of castor oil, which has hitherto been in great vogue, as well from the inaccuracy with which it is generally expressed, as from its act ing chiefly on the large, and but little or not at all on the small, intestines. But
after all, the patient must determine for himself; for though it may disagree with many constitutions, it will often occur in others, that there is no aperitite that completes its purpose so pleasantly. When castor oil does not agree, a little rhubarb, in combination with neutral salt, in the proportion of a scruple or half a dram of the former, and a dram of the latter, dissolved in mint water, may be resorted to, or the neutral salt alone in double the quantity now prescribed.
Where we have reason to suspect schirrosity of the liver, purgatives are of more consequence than in any other case : and here the more drastic kinds are to be preferred ; as jalap, colocynth, and scammony.
Peruvian bark seldom agrees with the stomach in any st age of this disease ; but bitter tonics will usually sit easy, and of ten afford considerable relief. If the pain be violent, opium must necessarily be had recourse to, but never otherwise.
When the sense of sinking in the sto mach is distressing, and particularly when this symptom occurs with cardialgia, the best stimulus is the compound spirit of ammonia, in camphor mixture, or in some other light vehicle : this is much less in jurious to- the digestive organs than nether, or any other strong-spirituous pre paration, or than aromatic confection, or any other spice In large quantity ; and it is frequently useful in conquering the pa. tient's habit of taking high-seasoned dishes ; it is sometimes not only useful, but necessary, to be gradual in breaking this habit, and it is commonly best to allow a few glasses of generous wine, re questing the patient at the same time to avoid all spirituous liquor ; a little wine is often well applied, as it stimulates him to take food which he would not otherwise touch, and enables him to digest it more easily. Here the diet cannot be too plain and simple : rice is one of the best vegetables, whether in gruel or in a solid form, and should be• duly intermixed with animal food, ei ther roasted or boiled, at the patient's option.
Bath water in moderation, and with strict attention to the state Of the bow els, often proves an excellent restorative. Soda water is one of the best beverages that can be•prescribed. Much 'walking usually induces dropsy, and should there fore be avoided; moderate exercise, how eve r, is of high importance, and it may be varied with great advantage by riding on horseback, in a carriage, and short excursions on the water.
There are several other diseases, which are also dependant on a vitiated state of the digestive organs, and are pecu liarly the objects of dietetic medicine. But, in general, they will be found of less consequence, and more easily subdued : they will be characterised by the slighter symptoms attendant upon those already noticed, and will yield to the common plan of medical regimen prescribed for their cure.