If a European lives for many years in the tropics he is likely to suffer from an illness in which the liver becomes enlarged. Post-mortem examinations show that this is because it is congested. Those physicians whose residence in the East makes them familiar with this disease are of opinion that the most important causes of it are exposure to great heat and errors in diet. Certainly they are supported in this view by the fact that lately the trouble has become much less frequent. Of late years the European residents in India have been taking leave from time to time, during which they have returned to England and also as a class they have been more careful in their diet, especially they have drunk less whisky. Plain simple food with very little alcohol and very little of highly spiced articles of food such as curry is important for those living in India. Failure to remember this increases the liability to hepatic congestion. During an acute attack the patient should take only milk, and in a chronic case the only dietetic directions that are necessary are that the food should be very plain and easy to digest. Unless the patient is careful about his food, improvement is impossible. Alcohol should not be taken.
No special diet is necessary for this condition, but the patient should take as abundantly as possible of such food as he will eat, for probably there is no disease which causes more rapid wasting, because there is the wasting due to cancer anywhere and frequently the primary seat of the cancer is in the stomach, and the indigestion produced by this contributes to the wasting. Further, if jaundice is present there is the wasting caused by the failure of the bile to reach the intestines and the consequent retardation of the absorption of fat; then, too the bile circulating in the blood causes indigestion. It has been shown that cancer anywhere in the body and especially in the stomach leads to a diminution of the hydrochloric acid in the gastric juice, and therefore it is desirable to prescribe this acid for these patients.
Here also no special diet is necessary, but as cirrhosis of the liver is commonly accompanied by gastritis, the dietetic directions should be the same as for this condition and they are given elsewhere. It goes without saying that the patient should not take any alcohol.
The diet should be the same as that given for any fever, whatever its cause. The other diseases of the liver do not require any special dietetic directions, and the only diseases of the pancreas that can be diagnosed are diabetes, the diet for which is given elsewhere, and cancer of the pancreas. The diet for the latter is the same as that for cancer generally, quite apart from its locality, but with this exception, that those who have disease of the pancreas cannot digest and absorb fats properly, and therefore the food should not contain much of them.