The liver is less subject to inflammation than most of the other viscera, as in it the circulation is slower; but when an inflammation does happen, it is with difficulty removed, and often ends in a suppuration or scirrhus.
CAUSES.——Besides the common causes of inflammation, we may here reckon the following, viz. excessive fatness, a scirrhus of the liver itself, violent shocks from strong vomits when the liver was before unsound, an adust or atrabiliarian state of the blood, any thing that suddenly cools the liver after it has been greatly heated, stones obstructing the course of the bile, drinking strong wines and spirituous liquors, using hot spicy aliment, obstinate hypochondriacal affections, &c.
SYMPTOMS.——This disease is known by a painful tension of the right side under the false ribs, attended with some degree of fever, a sense of weight, or fulness of the part, difficulty of breathing, loathing of food, great thirst, with a pale or yellowish colour of the skin and eyes.
The symptoms here are various, according to the degree of inflammation, and likewise according to the particular part of the liver where the inflammation happens. Sometimes the pain is so inconsiderable, that an inflammation is not so much as suspected; but when it happens in the upper or convex part of the liver, the pain is more acute, the pulse quicker, and the patient is often troubled with a dry cough, a hiccup, and a pain extending to the shoulder, with difficulty of lying on the left side, &c.
This disease may be distinguished from the pleurisy by the pain being less violent, seated under the false ribs, the pulse not so hard, and by the difficulty of lying on the left side. It may be distinguished from the hysteric and hypochondriac disorders by the degree of fever with which it is always attended.
This disease, if properly treated, is seldom mortal. A constant hiccuping, violent fever, and excessive thirst, are bad symptoms. If it ends in a suppuration, and the matter cannot be discharged outwardly, the danger is great. When the scirrhus of the liver ensues, the patient, if he observes a proper regimen, may nevertheless live a number of years tolerably easy; but if he indulge in animal food and strong liquors, or take medicines of an acrid or irritating nature, the scirrhus will be converted into a cancer, which must infallibly prove fatal.
REGIMEN.——The same regimen is to be observed in this as in other inflammatory disorders. All hot things are to be carefully avoided, and cool diluting liquors, as whey, barley-water, &c. drank freely. The food must be light and thin, and the body, as well as the mind, kept easy and quiet.
MEDICINE.——Bleeding is proper at the beginning of this disease, and it will often be necessary, even though the pulse should not feel hard, to repeat it. All violent purgatives are to be avoided; the body however must be kept gently open. A decoction of tamarinds, with a little honey or manna, will answer this purpose very well. The side affected must be fomented in the manner directed in the foregoing diseases. Mild laxative clysters should be frequently administered; and, if the pain should notwithstanding continue violent, a blistering plaster may be applied over the part affected.
Medicines which promote the secretion of urine have a very good effect here. For this purpose half a drachm of purified nitre, or a tea-spoonful of the sweet spirits of nitre, may be taken in a cup of the patient’s drink three or four times a-day.
When there is an inclination to sweat, it ought to be promoted, but not by warm sudorifics. The only thing to be used for that purpose is plenty of diluting liquors drank about the warmth of the human blood. Indeed the patient in this case, as well as in all other topical inflammations, ought to drink nothing that is colder than the blood.