230 DISEASES OF THE LIVER 



operation until all mucus is dissolved and the liquid flows 

 out clear. This treatment should be used at least once or 

 twice daily. Following the stomach lavage Carlsbad salts 

 (0.5-2.0) are useful to stimulate secretions and to dissolve the 

 mucus accumulated on the mucous membrane of the stomach 

 and duodenum. In some cases this will be sufficient to. allow 

 the escape of the bile into the duodenum. 



Injections of warm water or warm bicarbonate of soda 

 solution (2 per cent.) into the rectum as high up as possible 

 are often valuable to stimulate peristalsis, encourage defeca- 

 tion, and to produce alkalinity of the intestinal contents. 



Should constipation be present calomel (dog, 0.3-0.4; cat, 

 0.1-0.15) should be given and repeated in twelve to fifteen 

 hours if catharsis has not been established. Magnesium 

 sulphate (dog, 8.0-16.0; cat, 1.0-4.0) or castor oil (dog, 

 15.0-16.0; cat, 5.0-20.0) may be used for the same pur- 

 pose. 



In severe cases it is advisable to try to overcome the 

 obstruction to the duct and empty the gall-bladder, either by 

 mechanically compressing the liver by manipulation or by the 

 use of emetics. The latter method has proved to be the 

 most satisfactory. The action of the emetic by contracting 

 the abdominal muscles will often exert enough pressure upon 

 the liver and gall-bladder to force the bile out into the bowel. 

 An obstruction, such as mucus, parasites, foreign bodies, etc., 

 can thus also often be removed. 



When the bile pigments are deposited in the body in large 

 quantities, or the blood contains a large amount of unde- 

 posited bile salts, its elimination should be encouraged by the 

 use of diuretics. Potassium acetate or nitrate (dog, 0.20- 

 0.50; cat, 0.05-0.10) is to be given twice daily. 



General stimulants, such as camphor or ether, are indicated 

 when general depression and coma are observed. 



In severe cases normal salt solution given as an intravenous 

 injection is useful to assist in the elimination of bile and to 

 produce general stimulation. 



Faradization of the liver has been tried but its usefulness 

 is questionable. 



