Volume 7
Encyclopaedia medica / under the general editorship of Chalmers Watson.
- Date:
- 1899-1910
Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Credit: Encyclopaedia medica / under the general editorship of Chalmers Watson. Source: Wellcome Collection.
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![Gastric catarrh, as distinct from intestinal catarrh, is often a feature in congestion of the liver. The gastric juice may fail in its function whilst the intestinal juices and the assimilation of food in the intestine continue to be normal. In such a condition the congestion of the liver is secondary to the gastric condition, and evanescent in character, and not the cause thereof. Were the liver primarily hypememic, the whole alimentary canal would be affected simultaneously. In another group the intestinal tract is the primary seat of pathological change. Catarrh, ulcers, excoriations, inflammatory changes, or retained faeces give rise to abnormal chemical products which reach the liver by the portal vein and cause a local determination of blood. Auto-intoxication from this source reaches the system by way of the portal vein, and the liver is the organ disturbed in the first instance. The liypersemia of the liver may be but the first stage of the sequence which afterwards induces hepatitis and then cirrhosis or suppuration. According as the products absorbed are wholly bacterial in their nature, or bacteria accom- panied by the products of their life and death, so will the hypersemia end. The enlargement of the liver which occurs in the febrile state connected with the eruptive and other fevers is due to a general blood infection. The spleen is involved in the same lesioD, and frequently the kidneys, the lungs, the intestine, the brain, etc., show signs of functional disturbance. Malaria is a toxic agent belonging to this group, and yellow fever in its several forms probably affects the system in this fashion. So called menstrual jaundice is by some regarded as toxic in origin, and by others as a neurotic affection. At the grand climacteric, cases have been recorded in which congestion of the liver with slight jaundice has occurred, and even during suppression of the ordinary menstruation similar symptoms have been noted. The jaundice which accompanies influenza in some outbreaks is accompanied by a hyperaemia of the liver. The attack lasts from five to eight days, and the divergence of the biliary secretion is chiefly observable in the urine, although the skin also may be slightly tinged. Exposure to cold or sudden chill is popularly believed to be a cause of hepatic congestion, and one which will bear investigation. It is in the tropics that a chill upon the liver is most frequently observed, and it is during two periods of the day that there are special dangers from this cause. One period is just as the sun is setting, when the earth rapidly cools, when the perspiration is suddenly arrested, and when the clothing, damp from perspiration, acts as a cold wet pack to the surface of the body, lowering the temperature, chilling the surface, and driving the blood from the skin to the thoracic and abdominal organs. At yet another ])eriod of the tropical day is chill apt to supervene — namely, in the early morning whilst yet in bed. The natural fall in temperature which occurs diurnally about 4 a.m. is a frequent source of abdominal trouble, and hypera^mia of the liver particularly. In great heat the bed-clothes are thrown off, or one may have retired without any covering. As morning approaches, however, the cold wakes the sleeper and he almost involuntarily covers the abdomen with a blanket, a sheet, a jDillow, or whatever is at hand. The protection may have been applied in time and the effects of the chill prevented ; but, on the other liand, diarrhoea or a congestion of the liver may result. The Effect of a Tropical Climate on the Liver.—A young European when he first takes up residence in a warm climate finds that the continued heat acts as a stimulant. His physical energy for some months is increased and his digestive organs enjoy an increased functional activity. The liver would seem to partake in the excitement, and the result is copious motions, deeply stained by the colouring matter of the bile. After a time, however, certainly within twelve months, the functional higher activity seems to become exhausted; in course of time the bile diminishes in quantity, until, judged by the pallor of the stools, it would appear that the liver action is imperfect. Other symptoms elucidate the same fact, and a form of dyspepsia supervenes, accompanied by epigastric fulness after meals and a sense of sinking when the stomach is empty. Buoyancy of spirits disappears, lethargy supervenes, and several minor ailments, such as occasional headaches, attacks of morning diarrhoea, etc., bring out the full meaning of the effects of climate. In this state, if](https://iiif.wellcomecollection.org/image/b20414444_007_0025.jp2/full/800%2C/0/default.jpg)
