SUPPURATIVE HEPATITIS. 



mended, if the sufferings of the patient render it worth while to use 

 them at all. They draw blood from the anastomoses of the branches 

 of the portal vein, and thus lessen the lateral pressure in the portal 

 vein, and consequently the supply of blood to the liver. Laxatives 

 have a similar influence, particularly the neutral salts, as, by abstract 

 ing water, they also cause depletion of the intestinal veins, and thus 

 diminish the lateral pressure in the portal veins. For patients who 

 habitually suffer from hyperaemia of the liver, the mineral springs at 

 Homburg, Kissengen, Marienbad, etc., are particularly beneficial, for 

 the salts, in the form in which they there enter the body, can undoubt- 

 edly be used for a long time without injury. 



INFLAMMATIONS OF THE LIVER. 



For sake of convenience, we shall make a general division of five 

 forms of inflammation of the liver, of each of which we shall hereafter 

 give a more accurate description : 1. Suppurative hepatitis ; 2. Chronic 

 interstitial hepatitis, which, in its later stages is called cirrhosis hepa- 

 tis; 3. Syphilitic hepatitis; 4. Pylephlebitis ; and 5. Acute yellow 

 atrophy of the liver, which is reckoned among the inflammations of the 

 liver, at least by most recent pathologists. We shall not treat of the 

 last form till we have considered other affections of the liver, accom- 

 panied by jaundice, that are more readily understood. 



OHAPTEE II, 



SUPPUKATTVE HEPATITIS. 



ETIOLOGY. According to Virchow, the processes observed in this 

 form of hepatitis originally affect the liver-cells themselves. At first 

 these swell from imbibition of an albuminous substance ; subsequently 

 there is disintegration of the cells, and consequently of the parenchyma 

 of the liver ; finally, there are cavities in the liver which are filled with 

 the disintegrated elements of the tissue. On the other hand, Lieber- 

 meister thinks that his examinations prove that, in suppurative hepati- 

 tis, the process starts from the interstitial tissue, and that the disinte 

 gration of the liver-cells is secondary. The etiology of parenchymatous 

 nepatitis is obscure. It is rare in the temperate zones, but more fre- 

 quent in the tropics, particularly in India, although the old accounts 

 of its frequency there are overdrawn. 



Among the exciting causes, we may mention 



