Etiology

This disease is the ending of a life of debauchery. It comes from indulging the senses by way of eating and drinking, and gratifying lust. Lust enters into this derangement as a factor by bringing on enervation and helping to derange digestion and nutrition. There are several leading etiological factors given by medical authorities: the toxic, coming from the use of alcoholics; the infectious, which is said to come from specific fevers, syphilis, etc.; a type that comes from the congestion following heart disease, known as cardiac liver; and one that comes from obstruction of the bile-duct. There is a vascular cirrhosis, which is brought on from irritation, engorgement, and the developing of new tissue because of an oversupply of nutritive material in the organ. There are many other etiological factors given, but I think it unnecessary to mention them. The causes most commonly met with are overeating and alcohol-drinking.

Symptoms

Like many other diseases of the liver, this disease often progresses to full development without presenting many symptoms--this is what authorities on the subject say. I, however, incline to the belief that the premonitory or primary symptoms have been present for years, but have been ignored or not even noticed. It would be impossible for anyone to tipple for years without showing symptoms of irritation of the stomach and tumefaction of the liver; so these symptoms are primary, and it should be the duty of every physician to inform victims of this derangement of what they are bringing upon themselves. Unfortunately the medical profession has never considered it its duty to take the attitude toward patients of being "my brother's keeper;" indeed, too many supposed-to-be teachers of health have encouraged these victims in taking into the system the material that builds disease. For years the blood vessels in the region of the stomach and liver have been engorged because of the irritation produced by alcoholics. The tongue is furred in the morning; the bowels are irregular. Sometimes there is vomiting or mucus. In alcohol gastritis great quantities of this mucus will be thrown out at times; even hemorrhage from the stomach is not uncommon. Occasionally the hemorrhage is profuse, and liable to recur so long as the habit of drinking is continued. Hemorrhage from the bowels may take place in this disease before there is any blood thrown out of the stomach. The bleeding is often from the veins in the esophagus, because of the disturbed portal circulation. Indeed, there is not very much difference, except in degree, between this state of the liver, caused by alcohol poisoning, and the chronic state brought on from years of imprudence in the eating of starch, sugar, and fat. The alcoholic variety is always more intense, there is greater enervation, and the circulatory system throughout the body is more involved than in those varieties produced by imprudence in eating. In advanced cases, patients become dropsical--show general dropsy. Ascites is common.

Diagnosis

With a dropsical state of the peritoneum, the well-marked history of alcoholism, light-colored feces from the bowels, and hemorrhage from the stomach and bowels, the diagnosis is made.

Treatment

There is not much to be done. Patients may be tapped and water taken off, which will give relief for a short time; but the water certainly will return. The time for curing the case has passed, perhaps many years ago. When the liver is so organically disorganized and the auxiliary organs of the body are so deranged as in these cases, there is nothing to be done, except whatever palliation may be required to give the patient temporary relief.