The following is a good combination; it acts directly upon the liver, and at the same time tends to relieve the craving for alcoholic stimulants : 8. Acidi Nit.-Hyd. Dil. ass.
Succi Taraxaci Tinct. Nuc. Vomica 3vj. Extract. Cinchona Liq. 3iiiss.
Infers. Chiratce ad :5'xij.
Fiat mistora. Signa.—" A tablespoonful in a wincglassful of water to be taken four times a day before food." In a few cases Chloride of Gold has been credited with causing absorp tion of the new fibrous growth, and injections of Fibrolysin have been recommended.
Castaigne advocates opotherapy by feeding on fresh pork liver, and recommends the injection of Adrenalin into the peritoneal cavity. Methylene Blue has been used in the same manner; it is rapidly absorbed and eliminated by the urine.
When ascites sets in notwithstanding the change in the patient's habits and the use of the above remedies, these should be continued. Cure is still not absolutely beyond hope, and the writer has a few times seen recovery follow where tapping had been deemed necessary.
The treatment of ascites will be found fully detailed under its own heading, where surgical methods and the Talma-Morrison operation of omentopexy or epiplopexy for the cure of cirrhosis are referred to—i.e., the suturing of the liver and omentum to the abdominal wall with the view of readjusting the circulation through the new vessels formed in the resulting adhesions.
In hypertrophic cirrhosis (I lanot's l)isease), alcoholic abuse plays no causal part; little can be done save the administration of palliatives to relieve the symptoms which are common to it and to atrophic cirrhosis.
Porto-caval anastomosis has been recommended. Removal of the spleen has been successful in some cases. Cumston, believing that some cases of hepatic cirrhosis are caused by infection of the biliary tract from the intestine, recommends that the gall-bladder should be drained by chole cvstostomv in all cases of hypertrophic cirrhosis with jaundice not yielding to medical treatment.
Vomiting may be met by counter-irritation over the gastric region, with Ice and effervescing mixtures internally. Bismuth, Alkalies, Hydrocyanic Acid, Creosote Capsules and Morphia Perules gr. in each) may be tried. Papain or Pepsin is useful in some cases, and pepto nised food often may be very valuable when the condition of the gastric membrane is much deranged. haemorrhage from the bowels, haemor rhoids, diarrhcca, and other complications are to be regarded as more or less conservative, and not to be interfered with too soon; the only avail able treatment when the loss of blood is serious is to administer Calcium Chloride or Lactate in full doses.
bematemesis will often yield to large recta] doses of the Calcium salts in combination with Adrenalin by the mouth in urgent cases, but death may take place from the rupture of a dilated oesophageal vein near the stomach in spite of all treatment.