CAUSES OF CIRRHOSIS. 109 



" severe icterus." No particular etiology has been made 

 out, nor is there anything reliable respecting treatment. 

 (Lancet, August, 1876.) 



CAUSES. There are perhaps various conditions capa- 

 ble of producing, or' at all events rnay help to produce, 

 the different forms of adhesive inflammation of the sub- 

 stance of the liver now under consideration ; but the 

 most common, and indeed the most powerful cause in 

 this country is the habitual indulgence in " ardent 

 spirits." These forms of disease are in consequence 

 most frequently seen in London and other large towns 

 chiefly among the poorer classes, many of whom spend 

 the greater portion of their earnings in, and when that 

 fails even sell or pledge their bed for the purchase of 

 gin, and for this reason the granular or hob-nailed liver 

 known to the French as cirrhosis, has been familiarly 

 termed in this country the " gin-drinker's " liver a 

 disease commonly met with at the various London 

 hospitals. The influence of spirit drinking in causing 

 this disease has likewise been observed in France ; and in 

 the many cases published by the eminent Andral, all 

 are traced to spirit-drinking. He imagined that the 

 spirit produced irritation of the mucus membrane of the 

 stomach and duodenum, and spread through continuity 

 of tissue to the gall-ducts, and from thence into the 

 substance of the liver, or, that the achohol being 

 absorbed into the veins may act directly on the liver. 



The latter exposition is undoubtedly the correct one ; 

 as the spirit when absorbed by the blood-vessels, is 

 1 carried at once to the liver, and there exerts an imme- 

 diate and deleterious action on its tissues. In proof of 

 this observation some interesting experiments on the 



