74 SYMPTOMS OF 



mencement of the jaundice. For a more accurate 

 description of the anatomical character of Acute 

 Atrophy of the Liver we are deeply indebted to the 

 indefatigable labours of more recent pathologists, par- 

 ticularly Eokitansky of Vienna, and Budd. 



SYMPTOMATOLOGY. Acute Atrophy of the Liver pre- 

 sents symptoms of grave import, which ought not to 

 escape the notice of the practitioner. It is some- 

 times preceded by a preliminary stage; at other 

 times it manifests itself without the slightest warning. 

 The incipient symptoms present nothing very character- 

 istic ; usually they resemble the symptoms of an acute 

 ; o-enteric catarrh. A patient so I out 



of sorts, and simply complains of dulness and heau!- 

 ; the tongue is coated ; the bowels irregular, some- 

 times relaxed and sometimes costive; the abdomen is 

 tender, particularly that portion which appertains to 

 the re-inn of the liver: and the pulse is accelerated. 



Sooner or later, aometimea n<>t until after the lap 



several u -liuht jaundiced tint nes upon 



these derangements. This jaundice may exist in the 

 simple form fur from ei-'ht to fuiirtccn days, or 

 longer, before the local changes take place in the liver 

 and spleen, ha'morrhai, r es, an<; y M-rioiis nervous 



derangements which so prominently characterise this 

 disease become apparent. 



Acute Atrophy of the Liver runs a more or 

 violent career, and in severe cases death closes the 

 -scene at the end of twelve or twenty-four hours ; in 

 other cases after two or live days, and is scarcely ever 

 prolonged to a week or ten il 



In the severe types of the disease the premonitory 



