738 DISEASES OF THE GALL-DUCTS. 



sionally, appear to moderate the pain and shorten the attack. If this 

 be, nevertheless, protracted, and the region of the liver become very 

 sensitive to pressure, we should apply a number of leeches to the right 

 hypochondrium ; in such cases they appear to have a favorable effect, 

 although we cannot understand why. The patient not unfrequently 

 becomes so collapsed that, besides the above-mentioned remedies, we 

 are obliged to give analeptics. Pieces of ice are most efficacious for 

 the severe, and occasionally very obstinate, vomiting. Emetics and 

 laxatives, given during the attacks, increase the pain, and, moreover, 

 they may prove dangerous. On the contrary, after the attack, we 

 should administer mild laxatives for a while, so that any concrements 

 in the intestines may be evacuated as soon as possible. 



In inflammations and ulcerations of the bile-passages caused by 

 gall-stones, we must limit ourselves to the treatment of symptoms, as 

 we are unable to remove the exciting cause. Fluctuating abscesses in 

 the abdominal walls should be opened early ; any remaining fistulas 

 should be treated according to the rules of surgery. Obstructions of 

 the intestinal canal by large gall-stones are to be treated as previously 

 advised : severe and distressing pain should be relieved by narcotics. 



