Excerpt from Report of Professor Delafield's Lectures on the Practice of Medicine, 1888
The functions of the liver may be disordered either with or without structural disea of this organ. These disorders may occur by themselves, or be associated with disturbances of the stomach and of the intestines.
The cases may be conveniently arranged in two clinical groups:
1. Disturbances of the Bile-producing Functions of the Liver. - The quantity of bile produced is too small. This is followed by imperfect digestion of fats and peptones, and consequent loss of nutrition; by decomposition of the matters contained in the intestine, with flatulence and possible poisoning; by constipation.
The patients become anæmic, they are emaciated, or, although remaining fat, are feeble and flabby. The ingestion of fats is followed by distress. They are constipated, with flatulence and its associated pains. The fæces are hard and light-colored. The tongue is coated, the mouth and throat dry, with a bitter taste. The skin is pale and muddy-looking. The appetite is poor and capricious. The urine contains an excess of phosphate and oxalate of lime. There are headache, mental lassitude, abnormal sensations in different parts of the body. In the bad cases hypochondriasis, neurasthenia, hysteria, or melancholia may be developed.
Treatment. - The object of treatment is to increase the production of bile, and this is to be effected by improving the general health, and by using remedies which will increase the production of bile.
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