Inflammation of the Liver is either acute or chronic. It is a complaint that is much more common in hot than in temperate climates..

Inflammation of the Liver may be occasioned by violent exercise, by intense summer heats, by long continued intermittent and remittent fevers, by high living, and an intemperate use of vinous and spirituous liquors, but more particularly the latter, and by various solid concretions in the substance of the liver. In five cases out of six the exciting cause of the disease will be found to be the partial application of cold or wet when the body is heated, or over-fatigued by violent exercise. Derangement of the digestive organs, suppressed secretions, inflammations of other viscera, and mental solicitude, are also occasional causes.

The acute disease comes on with a sense of chilliness; pain in the right side; sometimes dull, sometimes sharp, extending up to the shoulder. The pain is much increased by pressing on the part, and is accompanied with cough, oppressed breathing, and difficulty of lying on the left side; together with nausea and sickness, and often with vomiting of bilious matter; the bowels are generally sluggish, and the stools show a deficiency of bile. The urine is usually of a deep saffron colour, and small in quantity; there is loss of appetite, great thirst, and costiveness, with a strong, hard, and frequent pulse, of from 90 to 100 in a minute, and sometimes intermitting; the skin is hot and dry, and tongue covered with a white and sometimes a yellowish fur; and when the disease has continued for some days, the skin and eyes become tinged of a deep yellow.

These symptoms are not always all of them present, or all equally severe; in some cases the fever is severe, in others scarcely perceptible; in some instances the pain is very acute and violent; in others, collections of pus have been found after death, when no pain had been felt. When the inflammation is seated deep in the substance of the liver, as that possesses little sensibility, the pain is usually obtuse, but when the surface is affected, it is acute, and apt to spread to the diaphragm and lungs, producing cough.

Inflammation of the Liver may be distinguished from Inflammation of the Lungs by the pain in the former extending into the shoulder; by the sallowness of the countenance; by the cough being unaccompanied by expectoration; and by the shortness of breath being comparatively trifling. It may be known from inflammation of the stomach by the heat and pain of the stomach not being increased upon taking anything into it; by its being able to retain whatever liquids or medicines are received into it, without immediately rejecting them; with little prostration of strength. It may be distinguished from spasm of the gall-ducts, by the pain being permanent, by the pulse being 100 and upwards in a minute, and by the patient always preferring to keep the body in a straight, quiescent posture; whereas, in spasm of the gall-ducts, the greatest ease is obtained by bending the body forward on the knees.

This, like other inflammations, may subside under proper treatment, or the inflammation may run on to suppuration, gangrene, or scirrhus, in which the liver becomes swelled and hard; but its termination in gangrene is a rare occurrence.

The disease is seldom attended with fatal consequences of an immediate nature, and is sometimes carried off by a haemorrhage from the nose or the bowels; by sweating, by diarrhoea, or by an evacution of urine depositing a copious sediment. In a few instances it has been observed to cease on the appearence of erysipelas in some external part.

Hydatids now and then form in or on the liver, and sometimes acquire so considerable a size and hardness, as to be distinguished with great difficulty from chronic inflammation terminating in suppuration.

A gradual abatement of the feverish symptoms; an improvement in the complexion, the strength not being much reduced, a return of the appetite, and an increase in the bulk of the body, are favourable symptoms. Intensity of pain in the region of the liver, a full and frequent pulse, considerable heat, thirst, dry skin, -costiveness, and frequent shivering, denote approaching suppuration. Abscess of the liver may be considered a dangerous di under any circumstances.

Treatment

The great object in treating acute inflammation of the Liver is to prevent the inflammation running on to suppuration, and the formation of abscesses. We must therefore employ leeches; applying them to the seat of pain; and repeating them as often as necessary; after the leeches, warm fomentations may be applied, or a linseed or bran poultice. Purgatives may be given freely. If the patient is an adult he may take:

Powdered Jalap...........................Half a Dram.

Cream of Tartar.........................Two Drams;

Which may be repeated forty-eight hours afterwards: Or he-may take a wineglassful of Black dose every morning;

If the patient is feverish, he may take the following:

Solution of Acetate of Ammonia..........One Ounce.

Sweet Spirit of Nitre.........................One Ounce.

Extract of Dandelion.........................Half an Ounce.

Water, sufficient to make....................Half a Pint:

A tablespoonful may be taken every three or four hours.

The diet may consist of gruel, milk, sago, corn starch, and things of that sort. When suppuration has taken place, or it is evident that it will do so; when the patient ceases to complain of pain, but has instead a feeling of weight in the region of the liver, and becomes distinctly hectic, a change must be made in the treatment. Instead of lowering the patient, the strength must be sustained by a more nourishing diet: and you must give Tonics. The following may be taken:

Sulphate of Quinine............................32 Grains.

Aromatic Sulphuric Acid.....................Two Drams.

Compound Tincture of Cardamoms.........One Ounce.

Syrup..............................................One Ounce.

Water, sufficient to make.....................Half a Pint.

Or the following:

Sulphate of Quinine:...........................32 Grains.

Diluted Nitric Acid............................One Dram;

Muriatic Acid..................................Halfa Dram.

Tincture of Orange Peel......................One Ounce.

Syrup..............................................One Ounce.

Water, sufficient to make.....................Half a Pint.

A tablespoonful to be taken every four hours, in a wineglassful of water.