80 PRACTICE OF PHYSIC. 



branous inflammation of the liver ; but I say the last is the 

 principal. We may here, as well as in the case of the lungs 

 (see CCCXXXIV.), suppose the two different cases : but, 

 besides the difficulties which I there stated, we have here a 

 proof of the argument which I employed : I said, that in cases 

 of apparent parenchymatous inflammation, where, upon dissec- 

 tion, an abscess or collection of pus appeared in the liver, in 

 ninety-nine cases out of an hundred, there were no previous marks 

 of inflammation ; and I believe such to have been chronic cases 

 in consequence of some congestion, some effusion which irritated 

 and produced an obscure inflammation in the neighbouring 

 parts, attended with purulency. I should say, therefore, that 

 parenchymatous inflammation of the liver is not in any case the 

 object of our practice as a primary inflammation.*" 



CCCCXIX. The hepatitis, like other inflammations, may 

 end by resolution, suppuration, or gangrene ; and the ten- 

 dency to the one or the other of these events may be known 

 from what has been delivered above. 



CCCCXX. The resolution of hepatitis is often the con- 

 sequence of, or is attended with, evacuations of different kinds. 

 A haemorrhagy, sometimes from the right nostril, and sometimes 

 from the hsemorrhoidal vessels, gives a solution of the disease. 

 Sometimes a bilious diarrhoea contributes to the same event ; 

 and the resolution of the hepatitis, as of other inflammations, 

 is attended with sweating, and with an evacuation of urine de- 

 positing a copious sediment. Can this disease be resolved by 

 expectoration ? It would seem to be sometimes cured by an 

 erysipelas appearing in some external part. 



CCCCXXI. When this disease has ended in suppura- 

 tion, the pus collected may be discharged by the biliary ducts ; 

 or, if the suppurated part does not any where adhere closely 

 to the neighbouring parts, the pus may be discharged into 

 the cavity of the abdomen ; but if, during the first state of 

 inflammation, the affected part of the liver shall have formed 

 a close adhesion to some of the neighbouring parts, the dis- 

 charge of the pus after suppuration may be various, accord- 

 ing to the different seat of the abscess. When seated on the 

 convex part of the liver, if the adhesion be to the periton- 

 aeum lining the common teguments, the pus may make its way 



