The liver is subject to one remarkable form of disease, which fortunately is not at all common, as it is not controllable as yet by any known plan of treatment, but is almost always fatal. It has been described by Dr: Budd under the name of softening, and by Frerichs as acute or yellow atrophy of the liver. In the worst cases, death may take place within twenty-four, or even within twelve. hours from the first appearance of the disease; in others, life may continue for from two to five days, but is seldom prolonged for a week.

It is not an inflammatory disease. There is at first, no fever, and the pulse is slow. The most prominent symptoms are vomiting,-first of mucus, and at length of matters like coffee grounds, -in other words, of altered blood; pains in the head, and delirium, frequently of a fierce and maniacal character; extreme restlessness; convulsions; trembling; stupor; dilated pupils; insensibility; death.

With the advent of these disturbances of the nervous functions the pulse becomes extremely frequent; and there is jaundice, unmistakable, yet not generally of a very deep hue.

There is generally tenderness on pressure over the region of the liver. The liver rapidly lessens in size; becomes soft, wrinkled on its surface, and flexible; and is pushed and flattened towards the spinal column. Of course, these last mentioned facts can only be ascertained after death. The rapid diminution of the liver in these cases is very surprising. The gland loses from one-third to two-thirds of its natural bulk. Dr. Bright has recorded cases in which its weight was reduced to two pounds, to twenty three ounces, to even nineteen ounces.

So far as experience has hitherto gone, the disease is one of adult life; it has been noticed more frequently in women than in men, and most especially in pregnant women. In cases which do not run so rapid a course, active purging has been found beneficial.

Acute inflammation of the Liver is apt to degenerate into chronic. The symptoms of chronic inflammation are some fulness and sense of weight in the right side, shooting pains felt at times in that region, uneasiness or pain on pressure, or on lying on the left side, occasionally some degree of jaundice, and sometimes a certain amount of fever. In fact, they are just the symptoms of acute inflammation occurring in a smaller degree.

Chronic affections of the liver are sometimes attended with an increase, and sometimes with a diminution of its size. When it is increased in bulk, the enlargement may be ascertained by examination; and the outline of the enlarged gland may sometimes be seen, extending beyond its proper situation, and passing far down into the abdomen. It will sometimes reach to the right groin, and when its left lobe is affected, it will sometimes stretch across towards the lower part of the left side of the belly. On the other hand, the liver may shrink into a much smaller space than it naturally occupies. These small livers are usually hard, and are more frequently attended with Dropsy than the large livers.

The "hobnail" liver, the cirrhose of modern French writers, is nobby as well as hard; the irregularity of its surface may be so great as to be perceptible to the touch.

When a large round boss can be distinguished, projecting from the surface of the liver, it is probably caused by a collection of hydatids, especially if the tumour has arisen without pain, or fever, or any material interference with the general health. When several smaller prominences are felt, rendering the enlarged liver uneven, and the patient's health is broken, they are probably cancerous. A smooth, globular, painless tumour, perceptible by the fingers near the margin of the liver, suggests the likelihood of a distended gall-bladder, especially if Jaundice occur. Then there is the "fatty" liver, which is frequently found associated with pulmonary consumption. The liver in this state is soft, enlarged, smooth on its surface, and of a buff or tawny colour throughout. Mr. Bowman has lately shown that these changes are owing simply to an unwonted abundance of fat; but there are no symptoms peculiar to the fatty liver. As to its cure, we are quite helpless, and the same may be said of the hobnail liver, as well as of nearly all those forms of disease in which the organ is affected with specific deposits. The most common effects of the constitutional poisoning of syphilis are said to be met with in the liver.

The same causes which produce acute inflammation of the liver, will also produce the chronic; more particularly indulgence in intemperance.

Treatment

When pain is felt in the region of the liver, with tenderness on pressure, leeches may be applied, succeeded by fomentations or poultices; and in some cases, blisters applied one after another, as the skin heals up, may be beneficial. Saline purgatives, as Epsom Salts, or Glauber Salts, in small doses (from a quarter to half an ounce) frequently repeated, are sometimes beneficial.

Much benefit is said to have resulted in liver complaints from the use of Dandelion. It may be taken in the form of Decoction or in that of Extract.

Take dried Dandelion Root, bruised........One Ounce.

Water..............................................One Pint and a half.

Simmer gently down to a, pint, strain, and take a Wineglassful of the liquid three times a day, or take:

Extract of Dandelion.............................One Ounce.

Water................................................One Pint; mix.

One or two tablespoonfuls three times a day.

The German Doctors are very fond of giving Muriate of Ammonia, (Sal Ammoniac) which they suppose has some specific influence upon the liver. It may be tried, if the Dandelion is not effectual, or it may be given at the same time. The dose for an adult may commence with five grains three times a day, and gradually increase the dose up to thirty grains..

Attention must be paid to the diet, which should be light and nourishing.