380 THE POPULAR SCIENCE MONTHLY. 



the stomach, or unwary enough to irritate the mucous membrane of 

 his stomach or duodenum by wines or spirits, the case is at once altered, 

 for now the swollen mucous membrane of the duodenum tends to close 

 the orifice of the bile-duct, or the congestion may even extend up the 

 duct itself. Thus an impediment, however slight it may be, is opposed 

 to the exit of bile from the liver. The pressui'e under which the bile 

 is secreted, as I have already said, is very small, and there being no 

 extra pressure put upon the liver by the diaphragm and abdominal 

 muscles, instead of the bile being at once forced out of the bile-capil- 

 laries it will remain in them, causing more or less congestion, and now 

 follows a whole series of disagreeable results. The bile, which may 

 be looked upon as a waste product of the liver, not being removed, the 

 other functions of the liver are disturbed. Assimilation becomes im- 

 perfect, we find lithates appearing in the urine ; the circulation in the 

 liver itself may be altered, and thereby the whole circulation in the 

 stomach and intestines may be impeded, for it must be remembered 

 that all the blood from the stomach and intestines has to pass through 

 the liver before it again reaches the general circulation. Thus the 

 individual becomes troubled with haemorrhoids, secretion and ver- 

 micular movement in the bowels are impaired, so that constipation 

 results ; congestion of the stomach, with loss of appetite, impaired 

 digestion, and flatulent eructations ensue, and the brain and nervous 

 system begin to suffer from the accumulation in them of their own 

 waste, or the absorption of abnormal products of assimilation. 



Feeling weak, dull, and melancholy, the sufferer now thinks he 

 ought to take meat three times a day, and perhaps, during the inter- 

 vals of his meals, to take strong beef -tea, or perhaps a glass of wine or 

 a nip of brandy. Yet, in spite of all this, he becomes weaker, more 

 stupid, and more melancholy ; and no wonder. He is simj^ly further 

 overtaxing his already overworked digestive organs. He is piling up 

 fuel, instead of removing ash, and choking the vital processes both in 

 his digestive and nervous systems. What he wants is not more nutri- 

 ment, but a more rapid removal of waste, and the change upon the 

 adoption of a proper system of ti-eatment is in many cases most marked 

 and satisfactory, both to the physician and the patient. 



The first thing to be done is to clear out the liver. This may seem 

 to be an unscientific expression, one adapted rather to popular notions 

 than in accordance with ascertained facts. But this is not the case. 

 In a former paper on the action of purgative medicines,* I have ex- 

 plained the way in which certain pui-gatives may be said to have the 

 effect of clearing out the liver, and first among those we must reckon 

 mercurials. In the case which we have just been describing, five 

 grains of blue-pill may be taken every night, or two or three grains 

 of calomel either alone or combined with extract of hyoscyamus or 

 conium, and this should be followed next morning by a saline draught. 



* " Practitioner," vol. xii, pp. 342, 403. 



