DISORDERS OF THE LIVER. 443 



bile enter the blood, circulate -with it, colour all the organs, 

 and are cast out in the various secretions, especially the 

 urine. 



Lastly, the glycogenic function of the liver may be dis- 

 ordered, and sugar make its appearance in the blood, urine, and 

 all the tissues, constituting glycosuria or diabetes mellitus. 

 Excess of sugar-yielding food may cause this, as we have seen, 

 but well-marked diabetes is generally referable to derangement 

 of the elaborate nervous and chemical processes of storing and 

 re-distributing the nutrient elements of the food carried on in 

 the liver. Hunger and wasting are therefore its prominent 

 symptoms, and thirst is also very urgent from the diuretic 

 effect of the sugar. In some instances diabetes may be traced 

 to injury or disease of the hepatic (" diabetic") centre in the 

 brain, or of the nervous connections between it and the liver. 



IV. NATURAL KECOVERY. 



Disorder of the liver disappears under favourable circum- 

 stances ; that is, with a return to the normal influences. Ke- 

 covery is assisted, on the one hand, by temporary abstinence 

 from food, brought about by loss of appetite, or even loathing 

 for food ; and, on the other hand, by excretion of the morbid 

 products. Excess of bile relieves itself naturally by bilious 

 diarrhoea. Nature requires guidance, however, in hepatic dis- 

 orders, for the languor, depression, and muscular debility which 

 it originates tend to give rise to further indisposition to exercise, 

 and thus to an aggravation of the eviL 



V. THERAPEUTICS. 



Hepatic disorder can only be prevented by taking a com- 

 prehensive view of the relation of the liver to the organs of 

 digestion, absorption, blood-formation, and excretion. The 

 income in the way of food and air must be thoroughly super- 

 vised. The diet must be definitely ordered. Perfect digestion 

 and intestinal activity must be secured. In many cases it is 

 found that when this has been done, little more is required. 

 Abundant bodily exercise must be recommended. The atmo- 

 sphere breathed must be as pure, cool, and bright as possible. 

 Sedentary or lazy habits must be changed for wholesome exer- 

 cise in the open air, in the form of walking or riding. In the 

 class of cases of disordered liver constantly met with in large 

 towns, change is essential from the foul hot dull atmosphere of 

 the workshop and dwelling, to the pure air of the parks or of 

 the country. But the beneficial effect of exercise on the liver is 

 not to be estimated solely by the amount of oxygen admitted. 

 It will also be evident in increased activity of the kidneys, 



