This disease comes on with shiverings, succeeded by heat, thirst, and other feverish symptoms; there is anxiety, with difficult respiration, often joined with a cough without expectoration. The patient complains also of heat, tightness and pain in the left side, which sometimes extend through the whole region of the abdomen, or shoot through the diaphragm, and into the left shoulder. The pains are increased on pressure. The pulse on the left side is sometimes partially suppressed, often intermittent, weak and slow. There is lassitude and loss of strength, watchfulness and sometimes delirium; dyspepsia, loss of appetite, vomiting of green bilious matter, and sometimes difficulty in voiding urine, from the kidney or bladder being affected: swelling in the region affected, representing the form of the spleen; faintings and bleedings from the nostrils at the height of the disease; but the most remarkable symptom that attends is the dark, bloody vomiting. At the commencement, the bowels are rather confined, but they soon become relaxed, and the stools are somewhat coloured by Mack blood. Like the liver, the Spleen is often attacked with chronic inflammation, and in time becomes enlarged and hardened. Sometimes suppuration ensues, and an abscess is formed. The Spleen is also liable to a peculiar enlargement, called Ague-cake, contracted during the continuance of Ague, in marshy countries. In this complaint the Spleen is sometimes enormously enlarged. The Spleen is also liable to tubercles; to deposits of other specific tumours, and of bone; and is also subject to softening of its substance. The Spleen is also subject to other disorders, which can only be ascertained after death.

Treatment

The best remedy for the Ague-cake is the remedy for intermittent fever, namely, Quinine, which may be given three times a day, in the absence of fever, in one or two grain doses. Purgatives are also said to have the effect of reducing the enlargement of the Spleen. Dr. Abercrombie strongly advises that, in diseases of the Spleen, Mercury should be avoided, or at least, such an employment of Mercury, as would risk tenderness of the gums. The late Dr. Robert Williams, St. Thomas's Hospital, after many trials, strongly recommended Bromide of Potash, in cases of diseased Spleen. It may be given in ten grain doses three times a day. In some cases of enlargement of the Spleen, Extract of Hemlock has proved of service. It may be taken in two grain pills, three times a day, for a grown person.

The diet must be according to the state of the patient, In acute inflammation of the Spleen, leeches may be applied to the seat of pain, and may be followed by blisters; and while any symptoms of fever remain, the diet must be light and unstimulating.