94 DISEASES OF THE DIGESTIVE APPARATUS. 



of cases, they do more harm than good; but enemas of warm water 

 two or three times daily are very useful. We can also try to empty 

 the gall-bladder mechanically by pressing the abdomen bet\veen 

 the fingers in the region of the kidneys; also by faradization — a 

 strong current is to be applied in the region of the liver on both 

 sides of the abdomen; this is to be kept up for ten minutes at a 

 time twice daily. Or by emetics, it being claimed that the com- 

 pression of the liver during emesis by the abdomen will often 

 empty the gall-bladder. We can also try to carry the bile out of 

 the system by the kidneys. The best drugs to use are mild 

 diuretics, such as acetate of sodium or potassium. Where there is 

 great debility or depression we can use spirits of camphor or 

 ether. Boldine, the alkaloid of the Penmus boldus, has recently 

 been spoken of as producing good results in jaundice ; it is given 

 in dose of 0.08 gm. daily. 



The other affections of the liver are of slight importance and 

 are rarely met with during life, consequently they will be only 

 mentioned briefly. 



Hypereemia of the Liver. 



This may be caused by either an increased or obstructed flow of 

 the bile, and, therefore, it is important to be able to distinguish 

 between the two. 



Congestive hyperaemia of the liver is a normal condition during 

 digestion, but it may be abnormally increased by eating large quan- 

 tities of food, especially if it is rich and irritating, and from want 

 of exercise ; decayed or tainted food may also cause this condition. 



Stagnating hypersemia of the liver may be caused by defective 

 valvular action of the heart or a weakened condition of that organ ; 

 in the later stages of acute diseases, such as the lungs; in cases 

 where large numbers of the lung capillaries become atrophied and 

 useless ; in great pleuritic exudations ; in extensive induration of 

 the lungs, with emphysema; and also in dropsy of the pericardium. 



Pathological Anatomy. The liver is greatly enlarged and 

 very hard ; when a section is cut in it the blood seems to run out 

 of it in large quantities. This blood is generally dark colored, 

 especially if the stagnation has been prolonged. The liver tissue 

 may be spotted, the surfaces corresponding with the central veins, 



