FATTY LIVER. 133 
The causes of fatty degeneration seem more varied. Following fatty infil- 
tration it may be attributable to the same influences. Certain poisons are also 
capable of producing it, notably arsenic. It may occur as a complication in 
acute infectious diseases of very severe type and long and tedious run; while 
now and then it has appeared to be a sequence of pernicious anemias or grave 
cases of poverty of the blood. 
In cases of general obesity, in which the liver is found to be enlarged but 
serious symptoms are absent, it will generally be safe to assume that the hepatic 
trouble is infiltration merely. If, on the other hand, the liver be reduced in 
size, and there is jaundice, occasional vomiting, and loss of strength, the diges- 
tive organs are habitually disordered, the victim, formerly obese, is now near or 
below the normal weight, and there is dropsy, the chances are many that his 
trouble is degeneration. But it is only in advanced and severe cases that 
important symptoms are manifested, hence a diagnosis is never likely to be 
made early, and while treatment could have good effect. As for the esssential 
treatment of fatty infiltration, obviously it is largely a modification in diet, 
which mainly consists of giving only sparingly the breadstuffs, various meals, 
potatoes, and other so-called starchy foods, which are notable fat-producers, and 
increasing the proportion of lean meat and vegetables that grow above ground. 
It is highly important also that ample exercise be encouraged. 
