438 DISEASES OF THE LIVER AND SPLEEN. 



from analogy, and from all we are able to observe in prac- 

 tice, there is every reason to believe tliat acute hepatitis not 

 unfrequently ends in the chronic form of disease. 



Prognostic. — An evident amendment, as soon as the 

 purgative has come into full operation, or speedily after- 

 wards, may be taken as an earnest of a favorable termina- 

 tion : should that and the fleam fail to give relief, there will 

 be cause for alarm. 



The Treatment required is simple. In the first instance 

 from four to six quarts of blood ought to be abstracted; and 

 this evacuation be immediately followed up by the exhibi- 

 tion of ten drachms of purging mass in a ball, or twelve 

 drachms in solution : the whole operation may be accele- 

 rated by the timely administration of a clyster. Calomel, 

 and indeed every other preparation of mercury, being a 

 stimulant to the liver, is to be scrupulously avoided. As 

 soon as we perceive the physic to be setting, should there be 

 occasion for it, we may take away another gallon of blood ; 

 and, at the same time — after having had the hair shorn off — 

 apply a blister to the right side, extending it from the 

 borders of the ribs as far forwards as the place of girthing. 

 The first dose of medicine once set, we may resume our 

 operation on the bowels, giving every other day the following 

 ball, omitting it only at such times as purgation shall have 

 re-commenced : 



Take of Purging mass .... 3iiss ; 



— Powdered nitre .... 3iiiss ; 



— Soft soap sufficient for a ball. 



Should the blister not have taken proper effect twelve 

 hours after its application, it may be repeated. In case the 

 disease appear to be merging into the chronic form, the in- 

 sertion of two or three setons through the skin of the right 

 side is very commendable practice. 



HEPATO-PERITONITIS — an appellation which will 

 serve to denote inflammation of the peritoneal covering or 

 capsule of the liver — is a disease of whose occasional ex- 

 istence post-mortem examinations furnish us with sufficient 



