INFLAMMATION OF THE LIVER. 131 
gently on the bowels. Magnesia well meets the requirement. It should be 
given twice daily while the stomach is empty, and be persisted in for a week 
or more if necessary. Two or three discharges each day, the same being semi- 
fluid, will be right. Neither calomel, blue-pill, nor other mercurials are required 
when the diet is properly regulated. 
INFLAMMATION OF THE LIVER. 
When the stomach and intestines are inflamed there may occur, in sym- 
pathy as it were, an inflammation of the liver, which physicians term hepatitis. 
This affection may also follow congestion, and it may come on alone. 
Two forms are recognized, the acute and chronic; but both are exceedingly 
rare, and the former is scarcely ever found except in very hot countries, in 
which the liver appears to meet conditions that are anything but congenial. 
The symptoms are much the same as those of congestion, only the sufferer 
seems worse, and there is greater tenderness on pressure on the right side, 
under the lower ribs. Vomiting and diarrhcea may also be present, induced by 
the irritant quality of the bile, while fever is a constant symptom in severe 
attacks. The manner of the patient is also suggestive. He becomes dull and 
listless soon after his liver is attacked ; but at times is very restless, evidently 
in consequence of pain. The position that he assumes on lying down would 
point to the liver, it being on his chest and abdomen, or his right side, never 
on his left. And when he gets up, he moves as though stiff and lame. 
Jaundice is rarely absent where there is much inflammation of the liver, and 
as a rule it appears within four days after the first symptoms are exhibited. That 
present, the pulse, previously full, bounding and rapid, falls below the normal. 
The course of acute inflammation is usually rapid, and may either terminate 
in recovery, resolve itself into the chronic form, or eventuate in abscess. In the 
latter instance death is quite sure to occur; and before it comes, a swelling 
over the region of the liver can generally be made out. A fatal end nearing, 
there is rapid emaciation, together with the usual signs of failure and exhaus- 
tion. The breathing is hurried, and the abdomen assumes the appearance of 
pregnancy. 
The “let-alone treatment” is much the safest and best in this affection. 
That is, withhold medicines, make the sufferer as comfortable as possible by 
judicious nursing, support him well by simple and easily digestible foods, and 
leave the rest to nature. 
Chronic hepatitis might follow the acute but it seldom does so; and very 
generally it springs from causes which act so slowly and insidiously that their 
character cannot be determined. Its victims are nearly, if not quite, all old 
