LIVER, DISEASES OF THE. The liver is sub ject to a number of disorders, circulatory, in flammatory, and infectious, some of which origi nate in the organ itself, while others arise from disorders in other parts of the body. It is in timately concerned with the processes of assimi lation and elaboration of food, and dietary indis cretions, especially if long continued, are certain to affect the health of the organ unfavorably.
Biliousness is an unscientific and inaccurate term used to designate a condition which presents the symptoms of languor, headache, dizziness, furred tongue, a tendency to constipation, with perhaps slight yellowing of the skin, and a gen eral sense of atony, depression, mid discomfort, and which is popularly supposed to be due to derangement of the liver. It depends not upon an excessive secretion of bile, but upon some per version of its function or its retention in the bile duets. _Moreover, most of the symptoms do not depend directly upon changes in the bile, but upon interference with digestion in the stomach and intestines, together with the development and absorption of an infinite variety of poisonous products of decomposition, many of which are muscular poisons. Normally these are not allowed to form, owing to the presence of the bile, but when this is retained in the bile-ducts, its secretion is impaired, and its composition al tered, by the disorder of the liver which is a reflex result of the gastric and intestinal irri tation. Biliousness is hest treated by careful regulation of the diet, avoiding what are called `rich foods,' sweet wines, and malt liquors. He patic activity is to be maintained and stimu lated by vigorous outdoor exercise. Massage over the region of the liver and gymnastics which contract the abdominal muscles are use 1 ful. Drugs which have an especial action on the liver (cholagogues) are given to promote the , flow of bile, and to overcome the constipation. Among the more important of these are mercury in the form of blue mass and calomel. podophyl lin, nitro-muriatie acid, and the saline purga tives. Laxative saline mineral waters may be
taken in the morning. See BILE.
Acute yellow atrophy is a remarkable disease of the liver in which the gland undergoes rapid degeneration, and diminishes to two-thirds or one-half its normal size. The malady is com paratively rare, and occurs after severe mental emotions, and in people whose constitutions are weakened by dissipation, by syphilis. or (in women) by pregnancy. After a period character ized by indefinite gastro-intestinal symptoms, such as nausea, vomiting, and irregularity of the bowels, the characteristic features of the disease appear. These consist of jaundice and marked cerebral disturbances, viz. headache and restless ness, then delirium and gradually developing coma, with convulsive twitchings toward the end. The disease is almost invariably fatal within a few days after the severe symptoms begin.
Congestion of the liver may be active or pas sive. Active congestion occurs in the course of fevers, and must form a part of acute inflamma tory processes. Passive congestion is caused by diseases of the heart or lungs, which interfere with the return of blood through the gland. A severe form of passive congestion is known as nutmeg firer. and results from valvular disease of the heart. The organ enlarges considerably and becomes darker in color and in advanced con ditions acquires a peculiar appearance of red, yellow, and white mottling.
Inflammatory processes in the liver may be acute or chronic, and comprise perihepatitis, abscess, and cirrhosis. Perihepatitis is a gradual thickening of the capsule of the liver caused usually by chronic alcoholism, syphilis, or the chronic peritonitis that sometimes accompanies Bright's disease. In some cases the thickened capsule contracts and produces marked interfer ence with the circulation of the organ, which as sumes an almost globular form. The portal cir culation in particular may be obstructed, and symptoms similar to those mentioned under cirrhosis result.