Secondary and Functional Diseases of the Liver. 435 



venting its reabsorption ; it proves antiseptic to the ingesta ; it 

 eliminates much of the peptone, saccharine and fatty matter from 

 the intestines and portal system thus relieving the liver materially ; 

 and it is supposed further to modify the other liver functions by 

 a direct action on the hepatic cells, and by reducing the cohesion 

 of fibrine, and promoting the disintegration of albumen. Certain 

 it is that calomel gives most substantial relief in many torpid and 

 other disorders of the liver and as it is not in itself an active 

 liver stimulant but has rather a soothing action on that gland it 

 can be safely resorted to in states of hepatic irritation in which 

 the more direct cholagogues would prove more or less hurtful. 



In some forms of hepatic disorder where a speedy and abundant 

 secretion is demanded, pilocarpin may be employed, with great 

 caution so as not to reduce the strength unduly by the attendant 

 diaphoresis, diuresis, salivation or diarrhoea. 



Alkalies have long been recognized as of great clinical value 

 in hepatic disorders. Though carbonate of soda decreases the 

 secretion of bile, (Nasse, Rohrig), yet the alkalies generally 

 appear to promote oxidation, and to hasten the disintegration of 

 albumen and the albuminoids. They increase the disintegration 

 of sulphur compounds materially adding to the sulphates and 

 urea in the urine. They further tend to increase the hippuric 

 acid, carbonate of soda (2 drs.) even determining the abundant 

 excretion of this acid in man (Nasse). It may be concluded 

 that the acknowledged value of alkalies in these diseases, is 

 largely due to their hastening of the metabolic processes in al- 

 buminoids. Small doses of sodium carbonate further stimulate 

 the gastric secretion and may thus benefit by rendering the pro- 

 cess of digestion more complete and satisfactory. 



Chlorine, Iodine, Bromine and their Salts. These halogens 

 are of great value in many hepatic disorders. The universal 

 craving for sodium chloride indicates the need of its elements in 

 the animal body, and whether this is mainly the supply of chlor- 

 ine for the hydrochloric acid of the gastric juice, or to fulfill its 

 uses in favoring the oxidation and disintegration of the nitrogen- 

 ous matters in the blood and tissues, or for other more or less 

 obscure uses, it is well to recognize and act upon the indication. 

 The various mineral waters which are held in high esteem in liver 

 affections contain a large proportion of sodium chloride. As a 



