LIVER. DISEASES OF Till:. The liver is subject to all those general morbid changes which, depending on disordered actions of the biousl.yerwels, modification of the nutritive process, or alterations in the blood itself, may affect moat organised parts of the body •, such are inflammation (hepatitis), acute and chronic; hypertrophy and atrophy; Induration and softening; and the different kind of tumours or trans formations of tissue, carcinoma, or cancer, medullary sarcoma, fungus hastnatodes, rnelanoais, and scrofulous tubercle. It is occasionally infostel by parasitic animals (hydatida), which may likewise affect other parts of the body.
But the liver is also liable to other diseases which appertain to it specially, and are connect"' with Its function—secretion. The che mical changes which give rise to the formation of bile in the liver may be so deranged, that one or all of the ingredients of that fluid are Increased or diminished in quantity, or vitiated in quality, and such -- — disorder of the secreting process may manifest itself In several ways : the imperfectly formed fluid passing into the intestines may cause irritation there, and consequently diarrhoea: or being absorbed into the blood, may produce jaundice and its concomitant symptoms ; or some of the ingredients of the bile may concrete into solid masses in the ducts of the liver or the gall-bladder, formiug gallstones. The diseased 'tato of the liver in which it becomes impregnated with an unnatural quantity of fatty matter may also be reckoned among the diseases appertaining to the special function of the organ, for the bile naturally contains a large proportion of fatty matter (cholesterine); though the chemical composition of this substance, and that of tho oil or fat with which the liver is impregnated in disease, appear to be different. [Levan, in NAT. 111ST. Dtv.] Congestion of the Liver.--The complicated structure of the liver renders it possible for various parts of its tissues to become congested. Thus there may be congestion from an increased secretion of bile, and in this case the bile duets are the parts principally affected. Then the hepatic veins, or the portal veins, may be congested, and this is called passive congestion ; whilst attire congestion is said to be present when the arterial capillaries are principally affected. Each of these forms of congestion is attended with peculiar morbid appearances, which have been discovered after death. In these congestions the liver is
generally enlarged. In certain states of congestion of the liver, the condition known by the name of nutmeg liver is present.
The most frequent cause of hepatic congestion is disease of the heart. When obstruction exists to the circulation, especially on the right side of the heart, the liver is liable to congestion. Such a state is attended with dropsical effusion of the abdomen, and also of the general cellular tissue. Temporary congestion of the liver may be also brought about by sudden chills, the cold stages of fevers, the drinking too largely of alcoholic liquors, injudicious feeding, and exposure to the beat of the sun. In congestion the liver is enlarged externally, there is sallowness of the complexion, the tongue is coated, the bowels constipated, the appetite bad, and there are sickness, vomiting, headache, and general debility. The pulse is slow, compressible, or irregular, or it may be quiet and feeble.
The treatment of congestion of the liver needs not to be very active. Gentle purgatives and diuretics, with rest, and a restricted diet, are generally sufficient.
Acute hepatitis, when it exists in a severe degree, is indicated pretty distinctly not only by the general signs of inflammation and symptom atic fever, such as thirst., heat, and dryness of the akin, increased rapidity of the pulse, &e., but also by local symptoms, which point more especially to the seat of the disease, namely, pain and tenderness on pressure beneath the ribs on the right side, difficult breathing from the liver being pressed upon by the diaphragm when air is drawn into the lungs, and a short dry cough, dependent either on the extension of the inflammation to the diaphragm, or a sympathetic affection of the parts engaged in respiration. The pain in hepatitis 80 frequently extends to the right shoulder, that pain in that situation has been considered characteristic of disease of the liver. Vomiting is a common attendant on hepatitis, as on inflammation of most of the abdominal viscera. Another symptotn is jaundice, which in this case is a conse quence of the inflammatory action having disturbed the process by which the components of the bile are formed and separated from the blood.