DIETETICS 



frpm unremitting 1 application to any fa- 

 vourite topic, and gently to remind him 

 of the harm he is about to do himself, 

 when he seems ready to give way to any 

 excess of passion. His resort to public 

 places will be beneficial, when he can be 

 brought to attend to what is going for- 

 ward there, and by such attentions his 

 pursuit of health will daily become less 

 irksome and laborious ; and by the same 

 means he must be brought to unbend 

 his mind in the society of his equals, and 

 to attend to the proper times of exercise, 

 food, and rest. 



HEPATIC AFFKCTIOX, catenating ~vith af- 

 fection of the stomach, and produced by 

 hot climates or hard drinking. 



We have already sufficiently comment- 

 ed upon the general nature of the bile, 

 and the importance of its due and healthy 

 flow towards the proper action of the 

 stomach, and the whole of the intestinal 

 canal. Now it is clear, that if the organ 

 which secretes this important fluid be 

 perpetually irritated by a stimulus of 

 every kind whatever, it will first become 

 inflamed, and suppurate, if the inflamma- 

 tion be very great and progressive ; and 

 secondly, it will become wholly exhaust- 

 ed and torpid, if the stimulus be not suf- 

 ficient to produce inflammation. 



The stimuli of hot climates and of hard 

 drinking, especially when the beverage 

 consists largely of alcohol, have both a 

 tendency to produce each of these ef- 

 fects, though not in an equal degree ; 

 and consequently not merely to injure 

 the liver itself, but to derange the entire 

 process and economy of digestion. 



In general, those who are affected by a 

 diseased state of the liver in warm cli- 

 mates return to their native homes before 

 inflammation sufficient to excite stippu- 

 Jation hns taken place ; and hence in our 

 own country we seldom meet with cases 

 of this kind : but if the same persons do 

 not return home in time, or if they be 

 actually prevented from returning at all, 

 suppuration will be a frequent conse- 

 quence of the disease they are labouring 

 under ; and it is therefore a result which 

 is by no means uncommon in the East 

 and West Indies. 



Commonly, as the case appears to us, 

 on the arrival of the patient in Europe, 

 the morbid excitement of the liver has 

 only produced an enlargement of its pa- 

 renchyma by the effusion of coagulable 

 lymph; which is often re-absorbed by a 

 recovery of healthy action in the lympha- 

 tics of the affected v iscus, and especially 



by gently stimulating them through the 

 medium of mercury. In the meanwhile, 

 however, the stomach and the whole of 

 the digestive economy suffers severely, 

 and much attention is necessary to the 

 nature and regulation of the diet. 



The excitement produced by hard 

 drinking, has a worse tendency, and is 

 often succeeded by a worse result to the 

 stomach, liver, and indeed all the chyly- 

 poietic viscera, than that produced by 

 hot climates. For, though in the former 

 case we have seldom morbid action 

 enough to produce suppuration, we have 

 enough to excite schimis, in conjunction 

 with torpidity, and consequently to ren- 

 der the organs almost incapable of recal 

 to a healthy and harmonious state by any 

 kind of regimen, or plan of medicine 

 whatever. AVhile, at the same time, 

 the villous membrane of the stomach, 

 from perpetual exposure to the acri- 

 mony of alcohol, becomes abraded of 

 the mouths of its secerning vessels, and 

 rendered often polished and glabrous 

 throughout its whole surface, like a sheet 

 of glass; whence the stomach is just as 

 incapable of secreting gastric juice as the 

 liver is of secreting bile. 



The symptoms chiefly indicatory of an 

 affection of the liver, from a long resi- 

 dence in hot climates, are, costiveness. 

 often alternating with diarrhoea, or dy- 

 sentery ; strong spasmodic pains about 

 the epigastriuiT), and hypochondria ; fla- 

 tulence, and at times cardialgia. There 

 is also a general languor and depression 

 altogether intolerable and insuperable to 

 the patient. If he indulge in activity, he 

 sinks into a state of increasing debility, 

 and if he attempt any moderate exertion, 

 he is overcome by fatigue, or suffers from 

 cold, or from some new symptoms, the 

 consequences of accidentally increased 

 action ; and unless some effectual, but. 

 moderate and permanent, means of re- 

 lief be afforded, he dies of some symp- 

 tomatic disease which ensues, or sinks 

 exhausted by the primary affection of the 

 stomach and other viscera concerned in 

 digestion. Such are the most striking- 

 features of disease originating from this 

 state of the abdominal viscera, when it 

 is severe and permanent. In the more 

 common attacks, a great number of symp- 

 toms are very troublesome : nausea, car- 

 dialgia, eructation, faintness, sense of 

 weight, and oppression in the epigas- 

 tric region, which is tender to the touch, 

 and pain between the shoulders. In al- 

 most every case, the appetite is exceed- 

 ingly fastidious ; if food be not taken, 



