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LIVER COMPLAINT. 
 
LIVER  COMPLAINT,
NERVOUS  DYSPEPSIA,
AND
HEADACHE:
THEIR CAUSES, PREVENTION, AND CURE.
s/
      Br M. L. HOLBROOK, M.D.,

EDITOR OF THE " HERALD OP HEALTH," AUTHOR OP " PARTURITION
    WITHOUT PAIN," AND "EATING FOR STRENGTH."
(f^t
THIRD EDITION.
    NEW YORK:
M. L. HOLBROOK & CO.
      1878.
 
vvic
ym+L
1876
 Copyright.
M. L. HOLBROOK
  18T6L 
PREFACE.
  Liver Complaint, Dyspepsia, and Headache are three
children of the Evil One which have  been allowed  to
propagate till there is no  family but suffers from their
presence.  They ar^e like weeds in a garden, sucking up
the nourishment  that should  go to feed  more useful
plants.  They are like wolves among sheep, carrying off
the choicest specimens only to destroy them.  They are
Hke thieves among honest  people, robbing them of their
earnings, and leaving them in poverty.  It is time the
trio were  attacked, uprooted, and routed.   Civilization
should not tolerate them any more than it does the wild
beasts that would carry off our children.  We should
fight  against  them as we do against vermin and  con-
tagious diseases.  The time has not yet come when it is
considered disgraceful to have them, but it is disgraceful
and sinful to the educated  and cultivated, nevertheless—
quite  as much  so as to be unable to read,  or write, or
speak  our own language  correctly; and  the time will 
VI                     PREFACE.
come when it  will be a greater disgrace to have head-
ache, dyspepsia, and liver complaint than to violate all
the rules of grammar in composition and speech.  The
author hopes to help on that day.  That the little book
here presented may do so is his earnest  wish.  That it
will, if rightly used, aid suffering mortals, victims to pain
and  disease, he certainly believes, and with  this belief
he sends it on its mission. It has been a labor of love, and
he only desires that it may do as much good to the
reader as writing it lias given pleasure to the author.
                                         M.  L. H.
  180 Fifth Avenue,
       New York, 1876; 
CONTENTS.
                                                     PAGE.
Contents.................................................  iii


Preface..................................................  v


                      CHAPTER  I.

General View of the Liver..................................   7

                      CHAPTER  II.

Functions of the Liver.....................................  13

                     CHAPTER  III.

The Bile : Its Quantity and Uses...........................  21

                     CHAPTER  IV.

Derangements of the Liver.................................  26

                      CHAPTER  V.

Torpid Livers..............................................  31

                     CHAPTER  VI.

Relation of the Liver to the Kidneys........................  35 
IV                     CONTENTS.


                    CHAPTER  VII.
                                                    TAGE.
Diseases Caused by Uric Acid...............................  39


                    CHAPTER  VIII.

Diseases Caused by Deranged Liver.........................  43

                     CHAPTER  IX.

Effect of a Deranged Liver on the Nerves...................  47

                     CHAPTER   X.

Effects of Disease of the Liver on the Heart.................  61

                     CHAPTER  XL

Causes of Liver Complaint..................................  64

                    CHAPTER  XII.

The Home Cure of Diseases of the Liver....................  69

                    CHAPTER  XHI.

Miscellaneous Questions Answered..........................  77


Influence op Mental Cultivation in Producing Dyspepsia, 95

Headache.................................................109

Notes Concerning Headache............................. 122

Index...................................................... 135 
THE   LIVER.
                   CHAPTER  I.
            G-ENEKA.L YlEW OF THE LlVEK.
   This little book which we purpose to write concern-
 ing  the liver will be plain and  simple, as far as it is
 possible to  make it so.   It is intended  to give general
 information on a subject quite too  little known about.
 This organ has long  been the scapegoat for multitudes
 of chronic infirmities, which were not well understood.
 Often  it is falsely accused  of  crimes  and  shortcomings
 of which, if it could speak, it would plead  " not guilty."
 Very often,  too, it has made trouble in  the organism
 which  no human skill could mend.   It  is  our intention
 to give information in these chapters as to what the liver
 is, and what it does;  so  that there  shall be more com-
 plete knowledge  among  all as to the use  and care of
 this  great organ.
  In the first place, it must be known  that the liver is
 a gland, or, rather, a multitude of small glands  bound
 together in  one  conglomerate body.  We may as well
inquire here what a  gland  is,  and answer  that  it is an
organ  in  the  body secreting  a  fluid of  some special
nature.   The word "gland" really does  not signify the
true  function of  this organ. "Gland" is from "gland- 
8
THE LIVER.
ula," an acorn, a kernel;  and the  small  glands of the
body do sometimes feel like little  kernels.  As an ex-
ample, we  may make  the  subject more plain by saying
that the  mouth is full of little glands, some of which are
of considerable size:  as the salivary glands, which se-
crete the salivary  juice.   Anyone  can  examine  the
salivary juice for himself, and thus  learn something of
the nature  of the work that glands have to do.  So, too,
the skin is  full of minute sweat  glands, whose business
it is to  perspire, and  thus pour out on the skin, where
they may be washed away, certain  substances no longer
useful.   The kidneys,  too,  are  glands, and  so are the
pancreas and spleen.  There is  a  gland on the neck,
called the thoroid gland, which sometimes swells up to a
great size,  and  forms what we  call goitre,  of which
most people have  seen examples.  There  is  a gland
over  each  eye, the lachrymal gland,  that secretes the
tears.   The stomach is full of  little glands, which se-
crete gastric juice to digest our food with.
   So it is seen  that our bodies  are full  of glands, out-
side and inside, each  having a  particular work to do;
and the liver is the largest of  them all, for it weighs
about  four pounds, and  is not far from one  foot in
length in its longest direction.
  Now let us take a look at it with the mind's eye; or, bet-
ter still, get a genuine liver from  a chicken or some other
small animal; for the illustrations we might put in do not,
after all, give much of an idea of how this organ looks. 
GENERAL VIEW  OF THE LIVER.
9
The liver is large.  It is also heavy.  It is unsymmet-
rical.   It has three lobes, and in color is brownish red.
It occupies a large space in the upper part  of  the  abdo-
men, just  under the  diaphragm, commencing  on  the
right side and extending across the  top  of the abdomi-
nal cavity, through the epigastric  region, and  partly
through  the left side.   Below it lie  the  stomach,  trans-
verse colon and right kidney. Behind it are the  verte-
bral column, aorta and vena cava, and in front the wall
of the base of the chest.  On top the liver is round, or
convex.  Below, it is partly concave and partly convex.
How this great mass is held up and  kept from pushing
the organs below it down—how it is kept from sinking
to the bottom of the abdomen—is a  question which will
naturally be asked here; and the reply is that there are
five ligaments that hold it firmly in  its place.   Four of
these are extensions, or duplicatures, of the peritoneum,
or  lining membrane of the abdominal cavity; and the
fifth is a round,  fibrous cord, resulting from the oblitera-
tion of the umbilical  vein.  Thus curiously is this old
channel of communication for the blood of the mother to
her unborn child turned, in after-life, to  use in helping
support  the liver.  So firmly, then, is the liver held in
its place that  nothing can displace  it but great abuse,
such as  very  tight corsets, or unnatural  pressure,  or
accidental  injury to the parts.
  We  said that the liver  usually  weighs about four
pounds, but one learned anatomist has found  that in  a 
10                   THE LIVER.
pretty well developed person it weighs about one-thirtieth
part of the weight of the body;  so that a man weighing
two hundred pounds would have nearly seven  pounds
of liver.   In childhood the liver weighs about the eight-
eenth part of the weight of the body;  so, when a baby
weighs  eighteen  pounds, there will  be of liver one
pound.   It may  be  interesting to  know  that  about
three-fourths  of the  entire body of an oyster is liver.
  The under surface of the liver is marked with fissures,
which divide it into lobes.  It is covered externally
with an extension of the lining membrane of the  abdom-
inal cavity.
  We said in the beginning that the liver was a con-
glomerate gland—that is, one large gland composed of
many small ones.  Each small  one is  called  a lobule,
and each one of  these is  about one-twenty-fifth of an
inch in diameter.  The lobules,  when cut across,  seem to
lie around each other, somewhat as the cells of a honey-
comb do. The spaces between each lobule are filled with
veins, arteries, nerves and bile-ducts; and a section mag-
nified is very beautiful.
  The vessels  that  pour their  contents into  the-liver
are:
  1. The portal vein.
  2. The hepatic artery.
  Those that come from it are:
  1. The hepatic duct.
  2. The hepatic vein. 
             GENERAL VIEW OF THE LIVER.           11

   The hepatic artery brings arterial blood to the liver,
but the portal vein is very peculiar, and we will give a
more complete account of its peculiarities.   It arises
from the  capillaries of the intestines, each little branch
joining with others till all are joined, and  contains  all
the blood that has  circulated through  all the walls of
the intestines,  and a large quantity of the newly digest-
ed food  which has  been absorbed from  the  digestive
cavity.   The  fluid, then, in the  portal vein is very pe-
culiar, especially just after  the food has been  digested,
it being a mixture of blood  and new, fresh nutriment,
containing the sugar, albumen, and  oily substances we
have  eaten.   During  the intervals of  digestion, when
there is no freshly digested food in the abdominal canal,
the blood of the portal vein is like the  blood from any
other vein.   Now the portal vein, instead of going right
back to the heart with its load, goes  directly up to  the
liver.  Once within the  liver it divides and subdivides
into minute veins so small  the eye cannot detect them,
making a  network that fills the whole  organ.  In this
minute  state  they  reach the  little  glandular lobules
before spoken of, pass  through them, and then  join
together again, until,  all joined, they pass out  of  the
liver under the name of the hepatic vein, which passes
on, joining other  great veins  of  the abdomen, till it
reaches the heart and pours its contents into the general
circulation.
  It must not be understood that all  the  food is  ab- 
12
THE LIVER.
sorbed and  passed into the  portal vein  through  the
liver; for this is also accomplished through the lacteals,
or, as they are called  in other  parts of the body, lym-
phatics.  Their chief  business  is to  absorb,  and they
are incessantly  engaged  in this  work.  They are  dis-
tributed  all through the  body, drinking up the trans-
parent, colorless lymph that is  found in  the  tissues.
When the  digestion of the food is in its  full activity,
they begin to drink up the  oily  and other particles from
the great  cavity  of  the intestines,  and  pass  it,  not
through  the liver, but by the  thoracic duct into  the
subclavian vein.
  The hepatic  artery carries blood to all parts  of the
liver;  and  finally discharges  its blood into the minute
branches of the portal vein just as they  go into  the
lobules.
  In our next chapter will be shown the functions of the
liver; but fearing that it will not be so well understood,
we prefer to state here that one reason why this organ
is often so lazy and troublesome is  that all  the blood of
the portal vein must be passed  through it, that the  bile
may be  secreted;  and very often,  like a filter,  if  this
blood  is overloaded  with  material that does not pass
through  readily, it becomes clogged, and then look out
for trouble. 
FUNCTIONS OF THE LIVER.
13
                   CHAPTER II.
              Functions  of the Liver.
   In the previous  chapter we gave a brief account of
the  structure of the liver,  and  spoke of it as a large
conglomerate gland, made up of a multitude of small
lobules, through which poured  the  blood from the he-
patic artery, and also the blood from the portal vein.
The size of one of these lobules may be imagined when
we state that twenty-five of  them lying side by side will
extend only one inch.  If you lay the heads of twenty-
five common pins close together, they will extend about
two inches;  so a liver lobule has not  far from half the
diameter of a pin-head.   With only the  naked eye we
should make  very  poor   headway  in  finding out  the
minute  structure of a liver  lobule.   It is only with our
microscopes that we can look into its anatomy.
   We have had engraved one of these lobules magnified,
so the reader can get an  idea of how it looks, and see
the vessels  that carry blood  to and  from it.  (See
Fig. 1.)   Figure 2 shows  several lobules lying side by
side, and somewhat  magnified.
   We now pass on  to the functions  or uses of the liver.
It has two chief duties—one to manufacture bile, and the
other to form sugar—and several of less importance. 
14
THE LIVER.
  With the  former most are  familiar,  and we shall
discuss it first.
  In the last chapter we traced  the ramifications of the
portal vein and  the hepatic artery throughout the little
Fig. 1.  View of a liver lobule and its vessels.
lobules that lie closely packed together, and make the
bulk of the liver.  As the blood passes through them,
these lobules take out of it certain ingredients and pass
them into the  bile-ducts, which  drain the -liver from
every part, and  unite and  reunite  into  larger  ducts
until at hist they make their exit from the  organ in  one
tube, or  sluiceway, draining the liver  very much as a
farmer would drain  a  large  and uneven  swamp into
which  poured a stream of water.   No organ has such 
               FUNCTIONS OF THE LIVER.            15

a perfect system of under-drains, and yet it gets clogged
much more frequently than is agreeable.  Inside these
little  sluiceways  is  found  a watery fluid  of  a  rich
brownish-yellow  color, and  bitter  taste.  This  is  the
bile.  The bile is, as we said, made from the blood
of  the  hepatic artery and portal  vein,  as it  passes
through the liver lobules, and it then passes  into  the
ducts which  surround each lobule, and is carried away.
As it  accumulates in the  smaller  ducts it passes  on,
filling the larger branches, which conduct it to  the main
channel on  the under surface of this organ.   At  this
           Pig. 2. View of a collection of lobules.
point the bile-duct communicates with  a sack or  bag,
called the gall-bladder, about three inches  long.  A
portion of the bile passes into this bag, especially during
the intervals of digestion, where it remains stored up for 
16
THE LIVER.
  future use.  Any  one can  find  the  gall-bladder  of a
  chicken,  or animal,  and  examine it at  his  leisure.
  The bile in the gall-bladder is of a  darker color  than
  that in the  ducts, owing, doubtless, to the  secretion of
  mucus.   The  amount of bile in  the gall-bladder is
  greater after long intervals between the taking of food.
  Immediately after digestion it  empties its contents into
  the  duct and  passes  it on  to the intestines, where it
  meets the food  from the stomach and mingles  with it.
  The appearance of the bile  in the  gall-bladder is  of a
  golden-brown color, and sometimes with shades of green.
  If any one will empty the bile from some animal into a
v  glass vial, and then shake it so as to mix it with the air,
  it will give a soapy appearance.
   The ingredients of the bile are, in 1,000 parts :
     Water..........................................880.00
     Biliary salts.....................................  90.00
     Mineral matter..................................  15.24
     Coloring  and fatty matter.......................  13.42
     Mucus ..,.......................................   1.34
                                              1000.00
   The quantity of bile secreted daily varies from two
  and a half to four pounds.  It is  least when the diet
  is mainly flesh, and  most  in vegetable eaters.   It is
  secreted from both venous and arterial blood, the minute
  ramifications of the portal vein and hepatic artery join-
  ing just as they pass through a lobule.   The flow of bile
  is greatest  soon after eating, and  when  the partly  di- 
FUNCTIONS OF THE LIVER.
17
gested  food passes from the  stomach  into  the duo-
denum.
   And now that we have traced the bile to its entrance
into the duodenum, it will be asked, Of  what use is it
here, and what is its function ?  Is it excrementitious or
not?   No physiologist has yet been able  to decide this
question.  The  fact that it is  secreted all the time, and
nearly  always found in the alimentary canal,  has  led
most physiologists to  believe  that it is  at least  partly
excrementitious.  The fact, however, that it is secreted
in part from arterial blood, and that the venous blood
which pours into the liver  from the portal vein is so
largely supplied with new material absorbed from the
food, and the other fact, that the bile is poured in such
large quantities into the  duodenum,  and there mixed
with the partly digested  food as it comes from the stom-
ach, seem to  us pretty  good evidence that it is  not
excrementitious, any  more  than  the  gastric  or pan-
creatic juices are excrementitious.
   Once in the intestines, the bile slowly  and gradually
disappears.  Abundant  in the upper  part  of the small
intestine, it  is less so in the middle part, and altogether
disappears in the lower part, so not a trace can be found.
There is little doubt that it has some value as an  aid to
the intestinal digestion,  and is again  absorbed into the
blood as a needful element of nutrition.
  That the bile is very  necessary  to life is known
by  the fact that if it  be not secreted,  or  if  it  be 
18
THE LIVER.
secreted and  not  allowed to  pass into the intestine, the
animal or man becomes enfeebled, emaciated, and soon
dies.
  Up to the year 1848 even physiologists supposed the
only important function of the liver was to secrete bile.
At  this date Bernard  announced to the scientific world
that he had discovered in the liver a new function—that
of forming sugar—and proceeded to show it by experi-
ments.  The variety of  sugar secreted is the same as
that found in the urine  in diabetes; but it is not, like
that,  passed out  of  the system to  its great  injury.
Indeed, it is not even passed into the bile-ducts as a part
of the bile; but  it is passed  through  the liver, and
emerges  with the venous  blood in the  hepatic vein.
Bernard examined the blood in all the other parts of the
body and the tissues, and found no sugar  in any of them
except what could be traced to the liver;  and  he  traced
it from this organ to the heart, then to the lungs, where
it seemed to disappear.  It is true that the portal vein,
which empties its contents into the liver, may contain
sugar, if it be taken in  the food, otherwise none is found
there; whereas the  hepatic  vein  does  contain  sugar,
whether any is taken in the food or not.   Indeed, to be
sure that the sugar was not derived from the food, most
of the experiments have been made on carnivorous ani-
mals, which use no sugar.
  The sugar formed in the liver resembles glucose, or
the sugar resulting from  the  digestion of starch.  The 
FUNCTIONS OF THE LIVER.
19
quantity is small.  It ferments readily, and is destroyed
in the animal economy with great facility.
  The use of the sugar formed in the liver is not well
known.  It almost always disappears in the lungs, and
probably serves  the same use as the sugar taken as food
—viz., the production of animal heat.
  Galen taught  that the liver was  the source  of animal
heat—the  stove, so  to  speak, that warmed the  body.
He also taught that it was the organ  that changed the
food  into  blood, and the starting-point of the  veins.
For sixteen hundred years this doctrine was generally
received; and even in the seventeenth century, Harvey,
who,, discovered  the circulation of the blood, taught it.
The discovery,  however,  of the lacteals and thoracic
duct, showed that a large portion of the food did not
pass through the liver at all, and at once this organ fell
from its high place below  its true one.  One eminent
physiologist wrote  an epitaph of the liver, in which the
end of its dominion was pronounced, and it was declared
to  be an  organ only  for  the secretion of  bile.   The
researches  of the last few years, however, go to partially
restore  it to its old place and power.   Observations go
to show that the  liver is, to some extent, a blood-forming,
blood-destroying and blood-purifying organ, that the
albumen and fibrin  of  the blood are disintegrated in
passing through  it, and substances  formed that the kid-
neys can eliminate.   It is calculated that the blood loses
a large amount  of fibrin in  passing through the  liver, 
20
THE LIVER.
and if at any time  this function  is destroyed the body
suffers, the accumulation of fibrin  being  a source of
acute  rheumatism  and other  diseases.  So,  too,  the
white  blood-corpuscles are believed to have  their birth
in the liver, and the red corpuscles are known to be de-
stroyed there. 
THE bile: its quantity and USES.        21
                   CHAPTER III.
          The  Bile : its Quantity and Uses.
   In  a previous  chapter  the quantity of bile  secreted
 daily  was stated  to be  from two  and a  half  to  four
 pounds.  Knowledge on this point is, however, limited.  .
 The amount must vary in different persons, and in the
 same person at different times.  It differs, no doubt, with
 the food, the health, the activity, the respiration, and the
 vigor  of the skin.   Dr. Murchison  says:
   "Although  the amount  of bile  secreted  daily must
 vary in different persons, and in the same  person under
 different circumstances, being modified by the quantity
 and quality of the food, the activity of respiration, and
 other  conditions,  it is  clear from  the facts  now ascer-
 tained that but a small proportion of what is ordinarily
 secreted is discharged from the bowel.  Berzelius found
 in 1,000 parts of fresh human feces only nine parts  of a
 substance similar to bile, which, on the calculation  that
 the daily feces  of a man  weigh five and one-half ounces,
 would  make a total of twenty-four grains of dried bile in
 a day. Now,  assuming that the  liver  secretes forty
 ounces of bile  in  a day, containing only five per cent.
 of solid matter, which is considerably below the average
proportion, the amount of dried bile secreted  in one day 
22
THE LIVER.
would  be 960  grains, or forty  times  the  quantity  dis-
charged from the bowel.  According  to Bischoff, man
discharges  about forty-six grains of the (altered) biliary
acids by the feces per diem, while Yoit's estimates give
170  grains as the quantity daily formed by the liver;
124  grains must,  therefore, be  otherwise  disposed  of.
Bidder and Schmidt have also found that not more than
one-eighth of the sulphur of the bile is normally excre-
ted with the feces.  The bile pigment is  generally be-
lieved to be all voided  by the feces; but this is clearly
not the case, if  there be any truth in  the view, already
referred to, that urinary pigment is formed  from bile
pigment;  while the fact, familiar to all clinical observ-
ers, that the bile pigment  discharged from the bowel is
greatly increased by calomel and other aperients, with-
out  any corresponding increase  of  secretion  by  the
liver, also seems to show that,  under  ordinary circum-
stances, much of the bile-pigment secreted by the liver
is not discharged with the feces.   It may be added that,
in carnivorous  animals and in snakes, although bile-
pigment is secreted in abundance by the liver, the quan-
tity discharged with the feces is even relatively less than
in man.
  " The question then arises as to  what becomes of  the
bile which is not discharged from the  bowel;  and it is
obviously one having an important bearing on the pathol-
ogy of many cases  of jaundice, as well as  upon  that of
many functional derangements of the liver.  The reply 
          THE BILE : ITS QUANTITY  AND USE8.         23

is  to be found in the fact that a large proportion of the
bile secreted by the liver is  again absorbed, either  by
the biliary passages, or by the mucous membrane of the
bowel.  From what is now known of the diffusibility of
fluids  through  animal membranes, it  is impossible to
conceive bile long in contact with the lining membrane
of the  gall-bladder, bile-ducts and intestine, without a
large portion of it passing into the circulating blood.
   " The constant secretion and reabsorption of bile is, in
fact, merely part of that osmotic circulation constantly tak-
ing place between the fluid contents of the bowel and the
blood, the existence of which is too little heeded in  our
pathological speculations and in  therapeutics, although
attention was  called  to  it  eighteen years ago by Dr.
Parkes.   ' It is now  known,'  says Dr. Parkes, ' that, in
varying degrees, there is a constant transit of fluid from
the  blood into the alimentary canal,  and as rapid re-
absorption.  The amount thus poured out and absorbed
in twenty-four hours  is almost incredible, and of itself
constitutes a secondary or intermediate circulation never
dreamed  of by Harvey.'  The amount of gastric juice
alone  passing into the stomach  in a day, and then re-
absorbed,  amounted,  in  the case  lately examined  by
Grunewald, to nearly twenty-three imperial  pints.  If
we put it at  twelve  pints we shall certainly be within
the  mark.  The pancreas, according  to Kroeger, fur-
nishes twelve pints and  a  half in twenty-four hours,
while the salivary glands pour out at least three pints in 
24
THE LIVER.
the same time.  The  amount  of  the  bile is  probably
over two pints.   The amount given out by the intestinal
mucous membrane cannot be guessed  at, but must be
enormous.  Altogether, the amount of  fluid effused into
the alimentary canal in twenty-four hours amounts  to
much more than the whole amount of blood in the body ;
in other words, every portion of the blood may, and pos-
sibly does, pass several  times into the  alimentary canal
in twenty-four hours.  The effect of this continual out-
pouring  is supposed to be to aid metamorphosis;  the
same  substance, more  or less  changed,  seems to be
thrown out and reabsorbed  until it be adapted for the
repair of tissue, or becomes effete.  How many  times
this cycle of movement is repeated before the bile is
extruded from the system we have no means of knowing,
but in the course of this osmotic circulation much of the
bile appears to  become transformed into products which
are eliminated  by the lungs and kidneys, while, at the
same  time, this circulation assists in the assimilation of
the nutritive  materials derived from the food.
   "In the first  place, it  assists in the absorption of fat.
It is a well-known clinical fact that when the common
bile-duct becomes obstructed, from any cause,  the fat
throughout the  body wastes.  Bidder and Schmidt like-
wise found that, after applying a ligature to the gall-duct
of a dog, the  animal absorbed  less fat  than before, and
there  was also a diminution of fatty matter in the chyle
in the thoracic duct;  the amount absorbed  was cal- 
THE BILE: ITS QUANTITY AND USES.        25
culated from  a comparison of the fat eaten with  the
amount passed in the feces.   There are also grounds for
thinking that  the entrance of bile into the bowels facili-
tates the absorption of the  albuminous constituents of
the food.   Some experiments of Bernard led him to  the
conclusion that gastric juice, when mixed with pancreatic
juice and bile, has a more solvent action on albuminous
substances than the gastric juice alone."
   From what has been stated, it follows  that the func-
tions   of  the  liver may be summed up  under  the  fol-
lowing heads:
   1. The formation of sugar, which contributes to  the
maintenance of animal heat, and to the nutrition of the
blood  and tissues, and the development of white blood-
corpuscles.
   2. The destructive metamorphosis of albuminoid mat-
ter, and the formation of  urea  and other nitrogenous
products, which are subsequently eliminated by the  kid-
neys—these chemical changes also contributing to  the
development  of animal heat.
   3. The secretion of bile, the greater part of which is
reabsorbed, assisting in the  assimilation of  fat and pep-
tones, and probably in those chemical changes which go
on in  the liver and portal circulation; while a small  part
is excreted, and, in passing  along the bowels, stimulates
peristaltic action and arrests decomposition. 
26                   THE LIVER
                  CHAPTER IY.

            Derangements of the Liver.

  From what has been said in preceding chapters, it will
be inferred  that  the  health of the body depends very
largely upon the  health  of the liver.  If it secretes its
bile normally and performs its other  functions health-
fully,  then the whole  body has the benefit  of its good
work.  But if, on the other hand, it is lazy, or excited,
or perverse, or weak, or idle, then come troubles innu-
merable.  There  is hardly an ailment  that is not or has
not been ascribed to it.   Diseases of the body and mind,
diseases and morbid tendencies of the heart or conscience,
diseases of the kidneys, lungs, stomach, bowels, nerves—
all have their origin in the liver.  So great is the num-
ber of diseases caused by torpid and fractious livers, that
it has become the habit of  many physicians, and  others,
to ascribe doubtful bodily  trouble to this organ.   Such
a course often indicates a physician's ignorance, and sat-
isfies  the patient  that his diseases are, after all, not very
serious.
  When we come to classify the diseases of the liver,
we find  they are few, but their symptoms and complica-
tions are many. The unprofessional reader gives a general
name to diseases of the liver.  He describes them  as 
DERANGEMENTS  OF THE LIVER.
27
" torpid liver," and, for his purpose, the name is perfectly
satisfactory.  It covers many of the functional diseases of
this organ. In former times, the physician gave, and even
now gives, to the functional derangements of the liver the
names " acute  inflammation,"  " chronic inflammation,"
and "congestion."  Dr.  Copeland, once  high authority,
arranges the diseases  of the liver under the following
heads:
   1. Increased secretion of bile.
   2. Diminished secretion of bile.
   3. Altered secretion of bile.
   This list of diseases, however, only recognized the  se-
cretion of bile as the function of  the liver, and did not
include the other functions of this organ.
   Dr. Murchison, the latest authority on functional dis-
eases of this organ, makes the following classification:
   1. Abnormal nutrition.
   2. Abnormal elimination.
   3. Abnormal disintegration.
   4. Derangements of the organs of digestion.
   5. Derangements of the nervous system.
   6. Derangements of the organs of circulation.
   7. Derangements of the organs of respiration.
   8. Derangements of the kidneys.
   9. Derangements of the condition of the skin.
   At first thought,  this  classification seems very far-
fetched ;  but, if carefully studied, we think it will be found
to be more in accordance with the popular term " torpid 
28
THE LIVER.
liver"  than any other, and for this reason we shall adopt
it, and draw somewhat from the work of Dr. Murchison for
material for this and future chapters.  If at first this classi-
fication should seem abstruse, we beg the reader not to
allow himself to be discouraged, but to try and master it.
We shall try to make the subject simple.  It must be
borne in mind, however, that the functions of the liver are
manifold, and not confined to the mere secretion of bile.
                 ABNORMAL NUTRITION.
  There are two forms  of abnormal nutrition to be con-
sidered : first, excessive fat;  second, emaciation.
  What the liver has to do with the accumulation or non-
accumulation of fat in the system may not seem clear. It
may be that the liver has in some instances an abnormal
power of converting the glycogen, or liver sugar, into fat;
or it may be that the sugar and starch of the food are, from
some defect of the working of the liver, converted directly
into fat instead of being  oxidized, and  thus corpulence
results.  One thing is very certain, fat people are apt to
suffer from constipation, drowsiness after meals, heavi-
ness, weariness, flatulence, and  all the symptoms of de-
rangement  of the liver; and it is well known that persons
who tipple are generally sufferers  from liver troubles,
and as these increase so also does corpulence.
  Excessive leanness, as  almost everybody  knows, is
generally associated with  derangement of the liver.  It
may be explained in various ways. 
DERANGEMENTS OF THE  LIVER.
29
  It will be remembered that one of the uses of bile is
to aid in the assimilation of fat.  As this fluid is poured
into the intestines it meets the partly-digested food, and
fits it for absorption.   Now, if the bile be deficient  in
quantity or vitiated  in  quality, the fatty matter will not
be  properly prepared for absorption;  consequently, the
fats in our food will not be absorbed, but pass out of the
body through the bowels.   Not only will  a deficient
flow of bile cause the non-absorption of fats, but also of
albumen and other products of digestion, and so the
muscular and  other tissues  will be starved,  and  ema-
ciation  be  the result.
  Emaciation, as well  as excessive fatness, may be the
result  of some derangement of  the sugar-forming func-
tion of the liver.  It  may occur in the following ways:
  1. One  of the functions  of the liver is to change the
starch sugar and glucose of food into liver sugar, a sub-
stance useful in building up  cell growth and maintaining
animal  heat.   Now if the liver fails to do this, the sugar
of  our  food  will  pass  directly into the circulation and
cause a disease known as diabetes, in which it is  carried
out  of  the system through   the  kidneys  without doing
any good.  Emaciation is one of the results of this dis-
ease.  According to some authorities, half the cases  of
diabetes are caused by this arrest of the power of the liver
to convert common  sugar into glycogen or liver sugar.
  2. Dr. Murchison thinks it not improbable  that other
wasting diseases are, in their  origin, connected with some 
30
THE LIVER.
functional derangement of the liver.   When there is de-
rangement of the disintegrative function of the liver, the
blood and fluid effused from it become loaded with effete
matter, as the result of which the nutrition of the tissues
is  often impaired and  the  body wastes.  In  phthisis,
again,  long before  tubercle is deposited in  the lungs,
there is evidence of deficient assimilation of nutriment
and  imperfect sanguification—functions  in  which we
know that the liver is deeply concerned.  Again, the
protracted purulent discharge which usually  precedes
waxy disease may entail a hasty and imperfect  sanguifi-
cation, resulting in anaemia and the formation of an
albuminous material little capable of organization.  We
shall learn more on this subject as we proceed. 
TORPID LIVERS.
31
                   CHAPTER Y.

                Torpid Livers.

  In popular phraseology, the sentence " a torpid liver"
is well  understood.  It means a liver that has lost its
power of healthy action.   All parts of the body have
their times of being torpid, so to speak; and this charac-
teristic  is not confined  to snakes and  toads and frogs,
that burrow all winter in caves and holes away from the
cold, nor to bears  and  such animals  as sleep for many
months at a time.  A limb may become  torpid and numb,
and its owner not be able to move it.  The whole body
may be torpid and inactive.  Even the mental part of
our nature may become very lethargic, through  indo-
lence  and laziness,  or  an insufficiency  of rich,  well-
oxygenated blood.  Although the expression "a torpid
liver"  is  more significant than almost any other, yet
it is hardly recognized in medical books.  The scientific
physician, who writes learnedly on this subject, rarely
mentions  any  disease  called  "torpid liver."   Cope-
land says one of the functional diseases of the liver is a
deficient secretion of bile.   Any one can see that only a
torpid liver is meant by this expression.  Dr. Murchison
speaks of abnormal  elimination; but this,  too, is  only
another name for torpid liver, as he himself declares at 
32
THE liver.
the end of a very interesting chapter on diseases of the
liver.
   Now this  abnormal  or deficient  elimination of bile
from the liver is a serious thing; for while the results
are rarely fatal at once, the distressing symptoms which
accompany them are exceedingly uncomfortable to those
who experience them;  and the accompanying lowering
of vitality,  which is no doubt  often the cause rather
than  the effect of torpid liver, may end in consump-
tion, bronchitis, or years of chronic invalidism.
   Some of the prominent symptoms of torpid liver are:
   1. An irregular and costive condition of the bowels,
with pale, whitish stools.
   2. Loss of appetite.
   3. A white  or yellowish furred tongue.
   4. A disagreeable, often bitter, taste in the mouth in
the morning.
   5. Flatulence.
   6. A sallow, muddy tint of the skin.
   7. A dingy white of the eye.
   8. Frontal headache.
   9. Dullness, heaviness and drowsiness after meals.
   10. Yery great depression of spirits—hypochondriasis.
   11. Unnatural urine, leaving a deposit of urate of
soda.
   To these  may be added occasionally, though not al-
ways, symptoms  of blood-poisoning, as  delirium, stupor,
muscular tremors, palpitation of the heart, convulsions, 
TORPID LIVERS.
33
etc.  These symptoms often give rise to mental aberra-
tion, to abnormal  views of life, to dark and gloomy an-
ticipations of the  future, to hopelessness, to lack  of
energy, to peevish temper, to excitement and  anger, the
breaking  of  friendships,  and the  destruction  of love
between  those who  have pledged themselves to love
each other faithfully till death.
  Now comes a very important question: Is the liver,
after  all,  entirely at fault for  all  these  symptoms?
Sometimes it may be, but more frequently much of the
torpidity  of  the liver  is  only an indication that  the
whole  system is torpid too; that the vitality is low-
ered, that digestion is  impaired,  that muscular tone is
deteriorated, and the nervous system weakened; so that
the fault is a general one of the whole body, and not a
special one of the liver.  Perhaps the blood is deficient
in quantity,  or bad  in quality, and  the liver cannot
manufacture  sufficient bile from it.   Perhaps the food is
bad, or insufficient exercise is taken.  The general belief
and teaching of medical men is that if the bile is not se-
creted  it  remains behind in the  blood,  poisoning  it.
Now it is very true that  the materials out of which
bile is made may be retained in the blood, rendering it
impure ; but it cannot be true that bile itself is retained
in the  blood, because it is not bile until it has been se-
creted  by the liver.   Besides bile  is not a poison.   It is
true that efforts  have been made by physiologists to
prove that bile injected  into the blood of an animal poi- 
34
THE LIVER.
 sons it so that it dies.  Well-water, or milk, or blood, or
 even air injected into the veins, may cause death; and
 yet none of them is a poison.   Further, bile has repeat-
 edly been injected into  the veins of animals without
 harming them more than the wound and operation  itself.
 Besides, if the  bile is such a poison, why should nearly
 all of  it  be  again absorbed into  the blood  from the
 intestines  with  the  newly-digested food ?  If it  were
 such a poison, it would endanger life constantly.  From
 this  point of view,  then,  the  principal  harm to the
 system through a torpid liver is from the  retention
 in the blood  of the  elements  of the bile, so  that they
 shall exist in excess.   But even this injury must be in-
 significant compared with  the  harm that comes from a
 failure of the bile in the intestines to perform  its  func-
 tions there.   The  bile is very  important  to  intestinal
 digestion, and, unless supplied,  the system  suffers  from
 defective  nutrition, an evil than  which there are few
greater. 
RELATION OF  THE LIVER TO THE KIDNEYS.     35
                  CHAPTER VI.

      Relation of the  Liver to the  Kidneys.

  One of the chief functions of the kidneys is the sep-
arating of urea  from the blood.  This substance consti-
tutes  the most important part of the solid portion of
urine.  In 1,000 parts of urine there are often as high as
twenty-five parts of urea—an amount  many times great-
er than  any other substance in it except water, which is
only a solvent and not  a product of the  waste of the
body.  And what is urea ?   It is one of the products of
the disintegration of  the albumen and  fibrin of the tis-
sues and blood.   It is pretty well established  that  urea
is largely formed by  the passage of the blood through
the liver.  In this organ the albumen and fibrin of the
blood are oxidized, and  urea is the result.  This urea is
exceedingly soluble,  and is very easily separated from
the blood  by the kidneys as it  passes through them.
It is also exceedingly  poisonous,  and if it accumu-
lates  dangerous symptoms supervene.  When the kid-
neys are in good health, so rapidly do they separate the
urea from the blood  that analysis reveals only a small
amount of it there.   According to modern authorities,
one of the chief diseases  of the liver is its failure to con-
vert a portion of the albumen and fibrin of the blood, 
36
THE LIVER.
as it goes through this organ, into urea.   From lack of
power, or some other reason, the liver only partly disin-
tegrates the albumen ; and, instead of perfectly  oxidizing
it, leaves it in the form of uric acid.  Now uric acid  and
its compounds, the urates,  while not so  poisonous as
urea, are much more injurious to the system, because
they are not so soluble nor so easily separated by the kid-
neys from the blood ; consequently they do, to some ex-
tent, accumulate, and, circulating in the blood, produce
serious and troublesome diseases
  There are few persons who at times do not  suffer
from an accumulation of  uric acid in the blood, and its
deposit  in the urine.  This  may be the result of taking
an excessive amount of food at a single  meal, and  can
be remedied by a return to regular habits of diet. But in
those whose livers are weak this may become the habit-
ual condition.  So, too, when a person is past the prime
of life the liver  becomes  debilitated;  and if the eating
habits of earlier and  more vigorous years are  main-
tained, its inability to convert the albumen into urea is
increased, uric  acid forms faster than it can be got  rid
of, and so it accumulates in the system  and is deposited
in various  ways  as urinary deposits.   Those  who  eat
much and exercise little are  sure to suffer.
  The symptoms of this fault of the liver are best  given
by Dr. Murchison, the highest  authority on this subject,
as follows:
  " The most common are the following: 
       RELATION OF THE LIVER TO THE  KIDNEYS.    37

  " A feeling of weight and fullness at the epigastrium
and in the region of the liver.
  " Flatulent distension of the stomach  and bowels.
  " Heartburn and acid eructations.
  " A feeling of oppression, and often of weariness and
aching pains in the limbs, or of insurmountable sleep-
iness after meals.
  " A furred tongue, which is often large and  indented
 at the edges, and a clammy, bitter  or metallic taste  in
the mouth, especially in the morning.
  "Appetite often good, at other times anorexia and
nausea.
  " An excessive secretion of viscid mucus in the fauces
and  at the back of the nose.
  " Constipation,  the  motions  being scybalous, some-
times too  dark, at others too  light, or  even clay color-
ed.   Occasionally attacks of diarrhea,  alternating with
constipation, especially if the patient  be intemperate in
the use of alcohol.
  " In some patients attacks of palpitation of the heart,
or irregularity or intermission of the pulse.
  " In many patients attacks of frontal  headache.
  "In  many  patients  restlessness  at  night  and bad
dreams.
  " In some patients  attacks of vertigo,  or dimness  of
sight, often induced by particular articles of diet.
  " All these  symptoms are liable to occasional aggra-
vation from  errors in  diet.   Gradually  the  patient is 
38
THE LIVER.
taught by experience to become more careful as to what
he eats or drinks.   One thing after another he is com-
pelled to  give  up.  First, he renounces malt  liquors;
then he discovers  that  port wine, madeira, champagne,
and burgundy  disagree, and he betakes himself for a
time to < dry sherry;' but at length this does not suit;
and after an interval,  during which a trial is made  of
claret  or hock, the patient,  probably  under  medical
advice, finds temporary relief by substituting, for wines,
brandy or  whisky  largely  diluted with  water.  At
last, unless he be misled by the  fashionable,  but,  to
my mind, erroneous, doctrine of the present day, that
alcohol in one form or another is necessary for digestion,
or to enable a man to get through his mental or bodily
work, he finds that he enjoys best health  when  he ab-
stains altogether from wine and  spirits,  and drinks
plain water.  The patient goes through a like experi-
ence with regard to solid food; one dish  after another—
very often what he likes best—has to be  given up; until
at length, if he be well advised, and  has the sense  to
follow the advice, he  restricts himself  to  the  plainest
food, in moderate quantity.  As a rule, those articles  of
diet which contain much saccharine or oleaginous mat-
ter are apt to disagree;  and not, as might perhaps have
been expected, nitrogenous food, if plainly  cooked.   In
most of these cases the  digestion appears to be strongest
in the morning, and the patient suffers from late din-
ners or suppers." 
DISEASES CAUSED BY URIC ACDD.         39
                   CHAPTER  VII.
           Diseases Caused by Uric Acid.
   Let us now see what trouble this uric acid causes in
the blood, see what diseases it brings on, and what other
injuries it effects.
   We all know that when our watches get dirty they do
not keep good time, but run  fast or slow, or even  stop
altogether.  So, too,  when the blood becomes  impure
the body cannot remain in  good health, but varies from
the true and high standard we should all aim for; and
I cannot avoid saying here  that, as most people  appre-
ciate  and like  to  carry a  watch that  keeps true time,
so should  they  also  like and try to own a body  that
maintains itself in a high state of vigor.
   One of  the diseases which results from  an accumu-
lation  of uric acid in the  blood is gout.   Fortunately
this is not so frequent a disease in this country as among
the aristocracy in  England, who eat more  and exercise
less than we do;  but there is some  gout  in our  own
country among the rich and overfed, and there is a great
deal more of what may be termed incipient gout, or
suppressed gout.   It is not  gout localized in the joints,
but it is a sort of gouty condition all through the tissues
and organs.  What is gout ?  It is only, so to speak, a 
40
THE liver.
condition in which there is a deposit of urate of soda
about  the joints.  When the blood  gets so full of uric
acid that it cannot hold it any longer, the acid is formed
into a  salt, and deposited about the joints; and  this is all
due, in the first place, to the inability of the liver to con-
vert albumen into urea. We might trace the subject back
still further, and  see that  the original cause was over-
indulgence of appetite, drink, or too little exercise;  but
this is  not necessary at the  present stage of our inquiries.
   Another disease—the  result of uric acid in the  blood
—is gravel; or, to call it by a more scientific name, urin-
ary calculi,  from the Latin word  calculus,  a  stone.
The uric acid, instead of  being  deposited  about  the
joints, is deposited in the  kidneys and bladder.   Urin-
ary calculi are very common in gouty people, and who-
ever suffers  from them suffers bodily torments  more ex-
cruciating than any human  being can imagine.
   Gall-stones, or  biliary calculi, are  only another form
of the same general condition  of the  blood; and al-
though gall-stones are  not identical in substance with
gravel, or the concretions  about the joints in gout, yet
they are believed to be caused by  the same  deterior-
ated condition of the blood.
   We  now pass on to consider a disease very dangerous
and  fatal, caused  by the same  general  disorder of the
liver—to wit, Bright's disease.   Dr. Murchison  says em-
phatically that it is caused  in persons advanced in age
by lithemia.   The result is that the kidneys become dis' 
DISEASES caused by URIC ACID.
41
organized and the patient dies.  Fatty degeneration of the
liver, and cancer of the liver, also have, it is  believed,
the same origin;  or, if not exactly the same, one very
similar :  the liver becomes weakened, and fails to do its
duty.  Uric acid in the blood is the result, and the liver
itself may, if the  course of life be  not changed, break
down in fatty degeneration.
   There is  a wonderful sympathy  between all  the or-
gans of the body, so that if one suffers all suffer  with it.
This is not perhaps so much the case in early life as it is
after  the decline of the bodily powers has begun.   We
have just seen how, when the liver is disordered, the kid-
neys suffer.   We now call the reader's attention to the
fact that when the liver suffers, every tissue of the body
suffers too.   The  poisoned blood, caused by  the  liver
not doing its duty, circulates in every part of  the body,
and weakens and poisons  every tissue.   Fatty  or calcar-
eous matter  is deposited  where good tissue is wanted;
the walls of the arteries grow weak, and perhaps burst,
letting a flood of blood into the brain, which causes apo-
plexy; the heart's valves weaken and  give out, and the
heart sends clots of blood through the arteries, plugging
them up  and causing serious  trouble.  We do not say
that the  liver is always the only faulty organ;  but  it  is
generally the one which, connected with  the  digestive
function, causes most disease
   I would gladly stop here, and  bring no more grave
charges  against so respectable an organ; but duty  com- 
42
THE LIVER.
pels me to say that  this  excess of  uric  acid in  the
blood may so weaken the powers  of resistance in the
system  as to make it very liable to attacks of inflamma-
tory diseases.   Persons suffering  from an accumulation
of uric acid in  the blood  are, if exposed, liable to take
cold, which, centering in  the lungs, causes inflammation
of these organs, accompanied by  fever.  There is little
doubt but in many cases it was the presence in the blood
of the  uric  acid  that determined the  inflammation.
Acute  rheumatism  is another disease  which  may have
the same cause; and so have scrofula, anaemia, chlorosis
—diseases  characterized by great  deficiency of healthy
blood and healthy tissue. 
OTHER DISEASES CAUSED BY DERANGED LIVER.   43
                 CHAPTER  VIII.
    Other Diseases Caused by  Deranged Liver.
  In former chapters we have referred with considerable
fullness to the effects of disease of the liver on the blood
and the system generally.  In this paper we shall speak
of the effects upon digestion and the functions of the
whole alimentary track, beginning with the mouth.
  The Mouth.—Not every case of derangement of the
liver shows its effects in the mouth; for the tongue may,
in spite of the liver, present in the morning a  clean or
nearly clean surface, and the mouth taste comparatively
sweet; but this is not generally the case.   In a  majority
of instances, the tongue will be coated in the  morning
of a whitish or yellowish white  or brown color. Some-
times the tongue presents a flabby appearance,  or looks
enlarged, and the teeth easily make indentations in it that
do not  at once  disappear.  Sometimes the papillae  on
the margin of the tongue become more or less congested,
enlarge, and  look  red and angry.  The  disagreeable
bitter taste in the mouth in the morning may generally
be traced to the derangements of the liver.   In  what
way this comes about is not quite clear; but there is one
constituent of  the  bile, taurocholic acid,  that is very
bitter, and  may be the cause of that most  disagreeable 
44                   THE LIVER.
taste that nearly every person can better understand than
describe.   In a perfectly healthy  person the  mouth
tastes sweet and feels clean  in the morning, and  this
should be  the  ideal  standard  that  all ought to try to
maintain.  Who knows how much of the lying and false
swearing, the loose, impulsive language and foolish talk
may come  from a mouth polluted by a deranged liver \
   Moebid  Appetite.—In  good  health the appetite is
free from  much variation, and craves only wholesome
and nutritious food.   In disease the  appetite varies, and
is either wanting, or slight, or capricious; or it is craving
and violent  in  its  demands, refusing to  be guided by
reason and good sense.
   In some cases the appetite  is good; but where the se-
cretion of bile is deficient, so that digestion in the  duo-
denum cannot go on vigorously, it is generally poor, and
food does not relish as it should.  This is especially the
case with food of a carbonaceous character, including the
oils  and fats.   These  substances  cannot  be digested
without the aid of bile, and if  there be no bile to digest
them, or if there be  too little  of it, then there will of
necessity be a loathing of such food.   This is one reason
why, in dyspepsia and  liver  complaint, so  many suffer
from cold hands and feet, defective  circulation and ema-
ciation.   There is not rich blood enough, or in sufficient
quantity, to fill up the arteries,  and warm and invigorate
the body.  The fault may not be entirely with the liver,
but much of it is. 
    OTHER DISEASES CAUSED BY DERANGED LIVER.    45

  Wind in the Bowels.—Flatulence is a characteristic
of disease of the liver.   Flatulence in the bowels  indi-
cates  defective digestion in  these parts  It  will be
remembered that,  beside its digestive power over the
fats, the bile exerts an  antiseptic property over the al-
buminous elements of food, preventing decomposition.
If, however, the bile be  deficient  in  quantity, then this
effect  is  lost,  and the  food decomposes as it passes
along  these  channels,  and  generates  the  gas which
causes flatulence.
  Irregular  Action of the Bowels.—No  one knows
better than a  person with a torpid liver how irregular
the bowels are apt  to become.   Sometimes constipation
prevails and sometimes diarrhea.  Nothing can be much
worse  than persistent constipation.   To lock up in the
bowels for days matter  that  Nature has rejected is very
injurious  to  the health.  There  may be other  causes
of  constipation than a deficiency  of bile, but this  alone
will cause it.   The reason is this :  the presence  of  a
normal quantity of bile  in the intestines stimulates the
peristaltic  action of the  bowels, and  prevents their be-
coming clogged up.
  On the other hand, the liver may be excited to unusual
action, after being torpid for some time, and for a short
time secrete too much bile, which will irritate the bowels
and cause diarrhea.
  Hemorrhoids.—Dr. Murchison  makes the  statement
that nearly all cases  of  this disease have their cause in 
46
the liver.
the liver.   We think he  has over-estimated it,  but we
give his statement as the latest high authority on this
subject.
  Sideache.—In chronic  torpidity of  the liver  acute
pain may not be present; but a dull, heavy, uneasy feel-
ing is pretty sure to exist.  So, too, when there is con-
gestion of  this.organ there is considerable  pain present.
Not all sideache, however, is  caused by disease of this
organ, for  it may come from slight inflammation of the
peritoneal  membrane investing the liver.
  Jaundice.—We cannot, in the brief space of this para-
graph, explain how jaundice is caused;  but it  is  a dis-
ease of the  liver,  and one  which no  person  cares to
have.   The  briefest  explanation  as to its  cause is that
the bile, after it is secreted, is again  absorbed into the
blood,  either from  obstruction  of  the bile-duct, con-
stipation, or  some other cause. 
effect or A deranged liver on the nerves.  47
                  CHAPTER IX.

   Effect of a Deranged Liver on the Nerves.

  We quote this  chapter  from Dr.  Murchison's able
work on the liver:
  "1.  Aching pains in the limbs and lassitude, com-
ing  on about an  hour  after  a  full meal, and some-
times associated with an irresistible tendency to drow-
siness, are very  common symptoms resulting  from he-
patic  derangement   with   uraemia.  They are often
attended by flatulence and other  indications  of atonic
dyspepsia.
  " 2.  Pain in  the  Shoulder.—It is well  known that,
in organic  disease  of the liver, complaint is often made
of a dull,  heavy, or aching pain  about the right,  and
more rarely about the left, shoulder-blade, which is ac-
counted for by the connection existing  between  the
branches  of the  subclavius  nerve  and  the phrenic.
Patients with uraemia often complain  of a similar pain.
  " 3.  Hepatic Neuralgia.—In rare  cases, a  neuralgic
pain seems to occur in the liver itself.  Many, probably
most, of the reported cases of ' neuralgic hepatis' have
probably been examples of biliary colic, where  the stone
has never  advanced beyond the neck of the gall-bladder 
48                  THE LIVER.
or the cystic duct, so as to cause jaundice.   Our experi-
ence would certainly lead us to doubt  the  purely  neu-
ralgic character of any such attack  in which the pain is
followed by jaundice, as has happened in some of the
recorded cases.   Other instances of supposed  hepatic
neuralgia have  probably been  examples of  nephritic
colic from renal calculi, where the pain,  as we have
known happen, radiates horizontally forward, instead of
taking the usual direction downward toward the pubes.
But, making  allowance for such mistakes in diagnosis,
a certain number of cases  remain  which appear to be
examples of true neuralgia of the liver.  Cases of this
sort have been described by Trousseau, Anstie,  and
other authors, and  a few have come under our notice.
The patients, in these cases, have been liable to  sudden
attacks, often periodic, of severe pain in the right hy-
pochondrium, and radiating thence  to  the  right shoul-
der, with tenderness  over one or  more of the  dorsal
spinous  processes.  They have been, for the most part,
of nervous temperament, and subject to neuralgic pains
in other parts of the body; and in most instances the
attacks  have been  attended with great depression of
spirits.   The cause of  the attacks is to be SQUght for in
a general neuralgic tendency, rather than  in any  dis-
order of the liver.   Trousseau, however, has  pointed out
that hepatic  colic  from gall-stones  may excite a  true
neuralgia.  After showing  how the peripheral irritation.
of a false tooth may excite facial neuralgia, he observes. 
    EFFECT OF A  DERANGED LIVER ON THE NERVES.   49

' The  same  thing  obtains  in  hepatic  colic.  Fearful
pams  set  up suddenly in the pit of the  stomach and in
the region of the gall-bladder and of the ductus com-
munis  choledochus.  So far there is merely local pain,
without neuralgia, and there is no tendency  on pressure
of the dorsal spinous processes; but, after two or three
days spent in acute pain, a  sharp pain is frequently com-
plained of in the seventh, eighth, and ninth intercostal
spaces, in the shoulder, in  the neck, and in  the arm  on
the same side; from that time neuralgia exists, and the
vertebrae become  very tender on pressure.'
   " 4.  Severe cramps in the legs  and different parts of
the body are a common symptom in persons who are the
subjects of  uraemia.  They often  come  on  during the
night,  and they are most  common  in  cold  and  damp
weather.  The  late Sir Charles Scudamore remarked
that, in some gouty persons, they produced such intense
suffering as to  form the leading  feature of  the disease.
Sometimes they precede a paroxysm of articular gout.
Two remarkable instances of this result  of uraemia have
been recorded by Dr. Bence Jones.  The first was that
of a gentleman aged forty, who for years had been liable
to constant  deposits of  lithic acid and lithates in the
urine.   He then became the subject of attacks of violent
pain in the stomach, coming on from one to five  hours
after a late  dinner.  The pain was intermittently spas-
modic;  the  most  intense  pain was reached  in half a
minute; it then relaxed, and returned as badly as before 
50
THE LIVER.
in two minutes.  His  suffering lasted  about an  hour,
when the pain gradually abated, leaving a tenderness on
pressure and an irritability after food for two or  three
days.  After the  attack, the  urine  always  deposited
lithic acid  crystals.  These attacks lasted for several
months, but, under a careful  diet they entirely ceased.
The second patient, who also was the subject of uraemia,
was seized with violent cramps in  the  rectum, coming
on six or eight  hours after food, and  lasting from half
an hour to  an hour.  The attacks entirely ceased under
the same treatment as that in the first case.
  " 5. Headache is a not unfrequent result of hepatic
derangement.   Most commonly it takes the form of a
dull, heavy pain in the  forehead,  more  rarely in the
occiput, complained of as soon as the  patient awakes in
the morning, and  either  speedily  ceases, or lasts the
greater part of the day or for several  days.  Such head-
aches are common in the subjects of  uraemia after any
indiscretion in  diet, or when the bowels are constipated.
Their immediate cause is probably the presence in the
blood of some  abnormal  product of albumen metamor-
phosis ; the derangement of the liver is usnally indicated
by pain and fullness in the right hypochondrium, flat-
ulence, and high-colored urine loaded  with lithates.
  " From these headaches it is necessary to distinguish
Megrim, which is the form of headache to which, unfor-
tunately, the terms ' bilious' or  ' sick'  are  still popularly
applied.  This  is neuralgia, which probably  in  most 
    EFFECT OF  A DERANGED LIVER  ON THE NERVES.  51

cases is in no way connected with hepatic derangement,
the bilious symptoms being the result, and not the cause,
of the attack, and the presence of bile in the vomited
matter being, as in  sea-sickness,  simply due  to the ur-
gency of the vomiting.  Although this view was enunci-
ated two centuries ago by Sydenham, and since his time
has been clearly set forth in many medical writings re-
cently published, it is still the fashion to attribute these
attacks to 'biliousness' or  to  'an excess of  bile in  the
system.'
   "But, while fully admitting that megrim is in no way
connected with retained bile, I agree with those authors
who believe  that certain cases of megrim are toxic in
their origin,  being  symptomatic of gout  and of some
other  disorders. The late Sir Henry Holland, in his
'Medical Notes and Reflections,'  described hereditary
periodic headaches  associated with gout, and he added:
'In conformity with this view, there is reason to believe
that  the  kidneys are the excretory organs most con-
cerned in giving relief in these cases, and principally by
an increased  separation  of  lithic acid and  its com-
pounds. '  Megrim,  as Dr. Liveing states, is sometimes
the expression of what is called a latent gouty  diathesis,
or, in other words, of uraemia.   A father may have
suffered  from gout, and his  son become the victim of
megrim.  In  some  patients  megrim  terminates when
they are attacked with  gout.   ' So evidently,' observes
Trousseau, ' is it (megrim) a  manifestation of the gouty 
52
THE LIVER.
 diathesis, that articular gout and megrim  are  observed
 in the same person, the one subsiding on the appearance
 of the other; and that it is often also the only expression
 of the hereditary tendency in subjects who are the  chil-
 dren  of  decidedly gouty  parents.   In  connection  with
 these observations^ I would  call attention  to certain
 cases, which have  come under my notice, of severe neu-
 ralgic headache occurring in connection with contracted
 granular kidneys,  and being sometimes  the first symp-
 tom for  which the patient has  sought  medical advice.
 The headache iu these cases  also was  evidently toxic,
 and in one instance fatal  coma followed  the  subcuta-
 neous injection of  a  quarter  of a grain  of  morphia.
 The headache has  been so severe that more than once I
 have known the case diagnosed as one  of cerebral tu-
 mor.  I have met  with these cases so frequently that I
believe it to be a good rule to investigate the  condition
 of the kid«eys in all cases of neuralgic  headache occur-
ring for the first time in persons of middle or advanced
 age, before having  recourse to treatment.
  " In this way, then, megrim may sometimes be traced
to hepatic  derangement, this  derangement consisting,
not in the retention of bile, but in that condition of liver
which we have found to  produce  uraemia; and,  in ac-
 cordance with this view, we have often noticed that me-
grim has been produced  by particular  articles of diet,
 and relieved by remedies which  unload the liver.
  "6.  Vertigo and Temporary Dimness of Sight.— 
    EFFECT OF A DERANGED LIVER ON THE NERVES.  53

Sudden attacks of giddiness  are in many instances sim-
ilar in their pathology  to megrim, and  giddiness  in
certain patients replaces  the  neuralgia.  But  giddiness,
according to my experience, is, in  a much larger propor-
tion of  cases, connected  with hepatic  derangement,
uraemia, and gout, and follows the use of certain articles
of diet such as tea, champagne, citron, etc.   Many years
ago, Boerhaave's commentator related the case of a man
who, during two years, was always seized with  vertig-
inous symptoms when he  attempted to stand up.   In
vain had the ablest practitioners endeavored to cure him.
Quite  suddenly he had an  attack of gout, of which  dis-
ease, up to  that date, he  had  no indication; and from
that moment  he found himself free from the vertigo to
which he  had formerly been liable.   A medical friend
of my own, who has long suffered from gout, as certainly
as he  drinks a cup  of tea or a glass of champagne, is
seized, often while walking  in the street, with sudden
giddiness; his head feels empty, and neighboring objects
seem to whirl round him; he does  not lose consciousness,
but he would fall did  he not lay  hold  of a railing.
After  a few seconds or  minutes,  the attack  passes off,
but in some  patients it is more  persistent.  Another
friend, who never has had  gout, but whose urine is
frequently loaded with lithates, was  seized  with dimness
|of sight and giddiness every night while writing.  He
took  iron, quinine, and  other tonics, but he  got  worse
instead of better.   He was advised to give up his pro- 
54
THE LIVER.
fession for a time, and try the effect of change of air;
but, before  taking so  serious a step, he  corrected  the
action of the  liver and  was  cured.  A third patient,
under my care, who  for years had been  subject  to
uraemia, but never had gout, would  be suddenly seized,
while writing, with dimness of  sight and specks floating
before the eyes, or even with complete, but  temporary,
blindness of one eye.  The symptoms were removed by
curing the liver.  Many  writers have referred attacks
such  as those which I have  now described  to derange-
ments of the stomach.   Trousseau, for example, who has
described them under  the designation of  'vertigo a sto-
macho laeso,'  speaks of them as associated with epigas-
tric pain, increased by food, flatulence, acid  eructations,
and vomiting of glairy mucus; but he admits that  the
gastric derangement, in which the vertigo is supposed to
originate, may  not  show  itself, and this admission cer-
tainly accords with our experience.   On the other  hand,
the circumstance  of the  frequent  association of  the
vertigo with gout or uraemia,  makes it probable that this
has a toxic origin, and  that the liver is the organ mainly
at fault.
  "7. Convulsions.—In January of the present year  I
saw a gentleman, about fifty-eight years of age, suffering
from cirrhosis of the liver.  He had all his life been ad-
dicted to the pleasures of the table, and had suffered
from  hepatic  derangements  as long  as  he  could  re-
member.   Six years ago,  he  became subject to severe 
    EFFECT OF  A DERANGED LIVER ON THE NERVES.   55

spasmodic twitchings in his legs, followed on three occa-
sions by several epileptiform seizures.  Shortly after the
last fit he had his first attack of gout, and since then  he
has suffered  repeatedly from the gout, but  there  has
been no return of the  convulsions  or  of the  muscular
twitchings.   There  is   no evidence  of  renal  disease.
Many similar cases  are, I believe, on record.  For ex-
ample, Van Swieten mentions the case of a man who had
violent  abdominal pains, accompanied by delirium and
general trembling, and  subsequently a severe attack  of
epilepsy.   From that date he had repeated attacks  of
gout, but no return of the nervous symptoms.
   "8. Paralysis.—I have  repeatedly  met  with  pa-
tients who  have complained  of numbness,  tingling and
pricking sensations, and a feeling of coldness or creeping
in the extremities on both sides, or only on one.  These
symptoms may be associated with headache, nausea, and
depression of  spirits,  and  often cause  needless alarm
by exciting  the suspicion that paralysis is imminent;
whereas if associated, as they often are, with evidence of
hepatic derangement, they may entirely and permanently
disappear under proper attention  to diet, exercise, etc.
   "9. Noises in the ears are common symptoms in gout,
and also in  uraemia independent of  gout.   One patient
has the feeling of a strong wind  blowing into the  ear;
another compares the noise to that of flowing water, or
of singing or buzzing; while in another the  sounds have
a pulsating character, corresponding to those of the heart. 
56                   THE  LIVER.
  "10.  Sleeplessness may, of course, arise from many
different causes, but one of its  causes is that derange-
ment of the liver which produces uraemia.  When this is
the case, the patient is often heavy and drowsy after a
full  meal, and he may fall  asleep at  once  on  re-
tiring to rest;  but, after one, two, three, or four hours,
he awakes, and then he either lies awake  for hours, or
he is constantly falling asleep, dreaming, or having the
nightmare and awaking—four or  five times, or even
oftener, in the course  of one  hour—until  the morning
comes, when he drops into a quiet  sleep of an hour or
more, or  he is obliged to get up  tired and irritable.
This sleeplessness,  like the vertigo  I have  already con-
sidered, is often induced by particular articles  of diet, or
by  some  unwholesome  combination  of them.   What
will  excite headache, giddiness, or disorders of the cir-
culation in some patients will in others  cause sleepless-
ness. Sometimes,  however,  this  symptom will occur
when the patient is  most careful as to diet.   What is im-
portant  also to note is that, in most cases, there are no
obvious symptoms of gastric dyspepsia; the appetite may
be good—too good, in fact—the bowels may be regular,
and there may be no pain, flatulence, or other  discomfort
after meals; but there will be found an unusual tendency
to the deposit of lithates  in the urine, and  very often
other phenomena of a so-called gouty diathesis.  This
form of sleeplessness was  described a century ago  by
Cullen,  in these words:  'Persons who labor  under a 
    EFFECT  OF A DERANGED  LIVER ON THE NERVES.  57

weakness of the stomach, as I  have done for a great
number of years past, know that  certain foods, without
their being  conscious of it, have  prevented sleeping.  I
have been awakened a hundred times at two o'clock in the
morning, when I did not feel any particular impression;
but I knew that I had been awakened  by an irregular
operation in that organ,  and I have  then recollected
what I took at  dinner, which was the cause of it.  Dr.
Haller is liable to the same complaint; and, in his larger
work especially, he  gives the  particulars of  his  own
case.'   The ,affection has  also  been well  described by
Dr. Dyce Duckworth in some excellent  observations, re-
cently published, on different forms of sleeplessness.  It
is, however, a form of sleeplessness not  generally under-
stood ;  and harm is often done to patients suffering from
it by the administration of opiates and  other soporifics,
by persons who are ignorant of its real cause.   Very
often  the  symptom will be greatly relieved, if not en-
tirely removed, by careful attention to diet, and particu-
larly by abstinence from wine.
   "11.  Depression of Spirits.—The  influence  of the
liver upon  the animal  spirits has been  recognized by
medical writers in all ages.  To  the belief in the exist-
ence of such an influence may be traced the origin of such
terms as Hypochondriasis and Melancholia.   Although
it is not contended that the morbid states of mind, to
which  at the  present  day we apply these terms, have
their origin in  the  liver, they  are unquestionably, in 
58
THE LIVER.
many instances, accompanied  and  aggravated by de-
rangements of this organ; and it is equally true that, in-
dependently  of either hypochondriasis or melancholia,
persons with functional derangement  or  structural dis-
ease of the liver are subject to fits of great depression of
spirits  and often groundless fears of impending danger,
which  cease  when the liver is  restored  to  its normal
state.
  " 12.  Irritability of temper is another common symp
torn of functional derangement of the liver, and is some-
times the first  indication of anything wrong.   A  man
who has previously borne the crosses of life  with equa-
nimity,  and been amiable to those about him, gradually
becomes disconcerted by trifles; his mind broods upon
them, and he makes all around him  unhappy, and him-
self the most miserable of all.   His relatives, perceiving
no  other sign of indisposition, and failing to recognize
the true cause, too often put down his  ebullitions of
temper  to  something mentally or  morally  wrong—to
moral  depravity, or failure to make any mental effort;
but measures calculated to restore  the liver to healthy
action, if resorted to in time, will often remove the irrita-
bility ; and either the  patient's improvement  under such
treatment or an attack of gout will reveal the cause of the
patient's bad temper.  In his 'Psychological Inquiries,'
the late Sir  Benjamin  Brodie thus speaks of  a patient
with a superabundance of lithic acid in the blood: ' Un-
comfortable thoughts  are presented  to his mind; he be- 
    EFFECT OF A DERANGED LIVER  ON THE NERVES.  59

comes  fretful and peevish, a trouble to himself, and, if
he be not trained to  exercise a moral restraint over his
thoughts and actions, a trouble to every one  about him.
After a while the poison, as it were, explodes; he has a
severe attack of gout in his foot; he is placed on a more
prudent diet; the system is relieved of the lithic acid by
which it was poisoned.   Then the gout subsides, happy
and cheerful  thoughts succeed those by which the  pa-
tient was previously  tormented; and these continue until
he has  the opportunity of relapsing into his former
habits, and thus earning a fresh attack of the disease.'
  " 13.  Cerebral Symptoms and the  Typhoid State.—
It is  well known  that restlessness,  delirium, stupor,
coma,  subsultus, tremors, convulsions,  a dry,  brown
tongue, and other phenomena of the 'typhoid state,' are
apt to supervene in certain cases of advanced  disease of
the liver, whether attended by jaundice  or not.  These
symptoms  have been usually attributed to  a  suppressed
secretion of bile.  But the assumption that the elements
of the bile are preformed in the blood, and  are merely
separated from  the  blood by the liver, we have already
found to be  devoid of  foundation; and  we  have  also
found that  bile is far from being, as commonly supposed,
a deadly poison; and that its presence in the blood, even
to saturation, does not give rise to cerebral  symptoms.
The cerebral symptoms referred to are often most severe
when the jaundice is slight, or when there is none; and
they are readily accounted for by the knowledge of the 
60
THE LIVER.
disintegrating function  which the liver is now known to
perform.  When this function of the liver is arrested  or
seriously impaired, urea is no longer  eliminated in suffi-
cient quantity by the kidneys; lithic acid and deleterious
products of disintegrating  albumen even  less oxidized,
such  as leucin  and  tyrosin,  and  perhaps  others with
which we are  as yet imperfectly acquainted, accumulate
in the blood and tissues; and the result is the develop-
ment  of symptoms  of blood-poisoning similar to  those
which arise  when the kidneys are unable  to  eliminate
the products of albumen disintegration, owing  to disease
of their own  structure, or to  an excessive formation of
urea and other products, as happens in  many febrile dis-
eases.   In acute  atrophy, for example,  the structure of
the liver is destroyed and its functions  arrested;  leucin
and tyrosin take the place of urea in the  urine, and are
also found in  large  quantities  in the liver, spleen, and
kidneys, while cerebral  symptoms and the typhoid state
are prominent features of the disease." 
EFFECTS OF DISEASE OF THE  LIVER ON THE HEART. 61
                  CHAPTER  X.

  Effects of  Disease of the  Liver on  the Heart.
  The heart is sometimes affected  by derangements of
the liver, though more frequently  by distention of the
stomach and indigestion.  The most common symptoms
are palpitation, irregularity of rhythm, and pulsation of
some of the  larger arteries. Impurities in the blood, too,
as they pour into and through the heart, affect its regular
action and cause it  to suffer.   If these conditions con-
tinue a long time, the muscular tissue of the  heart grows
weak, and debility of the organ  is the result.   With this
condition follows  a  long train of depressing symptoms,
melancholia, etc., not easily understood.  Patient  and
friends, and even  the physician attribute it to the imag-
ination, that scapegoat for so  many of the  nervous dis-
orders  of human  beings.   And here we  may say that
these so-called imaginary diseases are, except in a few
cases, the result of defective nutrition and  circulation, or
of poisons in  the blood, or  disorganization  of some of
the nervous  tissue ; and they are to be cured by building
up the system rather than by any other means.  When
the faculties are strong and well nourished with rich,
pure blood we imagine themselves well, and  are well; 
63
THE liver.
but when they are weak and fed by thin, impure blood
we have not the strength to imagine ourselves sound,
and really we are not sound.
   There is another sensation which dyspeptics and those
with  deranged livers generally feel which is worth not-
ing here.  It  is a beating or throbbing sensation in the
large arteries of the body.   It is often felt in the large
artery that carries the blood down from the heart in the
region back of the stomach and upper bowels, and is some-
times very distressing.  This symptom, too, may occur in
dyspepsia as well as liver complaint.   Its cure depends
on the general invigoration of the system.
   The pulse in health should beat with regularity ; this
is a sign of integrity of the heart and the body generally.
In those morbid states of the liver which poison the blood
through and through, the heart shows it by beating irreg-
ularly, as previously mentioned.  This may be caused by
disease of the heart or by nervousness.  This  irregular-
ity sometimes amounts to an intermission of one beat. If
there be no heart disease, no flatulence or indigestion,
no nervousness or old  age, then the cause is  likely to
be a  derangement of the  liver.  In cases of  long-con-
tinued and  serious  liver derangement not only may the
pulse intermit, but become feeble.   In  all such cases the
usual remedies are iron,  quinine, liquors, etc. ; but tliia
treatment generally does more harm than good.
  Angina pectoris may  arise from liver complaint, and
catarrh, bronchitis, asthma,  boils,  some forms  of skin 
   EFFECTS of disease of the liver on the heart. 63

disease, discoloration of the skin, and many other diseases
may come from deranged livers.
  Our catalogue of charges against the liver has become
quite large, and  yet we might have  extended it.   It
is too bad, however, to add to the list, as the reader may
become discouraged.  We purpose here to rest this part
of our case, and go on to  what most people are interested
in—the causes of liver complaint and its cure. 
64
THE LIVER.
                  CHAPTER  XL
            Causes of Liver Complaint.
  It is exceedingly important, in discussing the derange-
ments of the liver, that we find out, if possible, the causes
which produce them, otherwise no progress can be made
in their treatment.   All successful treatment must be
based first on the removal of these causes.   Let us there-
fore  at  once set ourselves about  the task fearlessly and
earnestly.   In general, then,  they may be  divided  into
two classes :
  1.  Those existing in nature.
  2.  Those pertaining to the individual.
  Of the first we will only briefly mention:
  1.  Miasma.—This when breathed depresses the vital
powers, and thus lowers the vigor of the organs.  Among
the various kinds of miasma is the poison which causes
fever and  ague,  which has  a specially injurious effect
on the liver.
  2.  Water.—Not only may poisons be taken into the
blood through the  lungs, but, by means of water  and
food, through the stomach.  It is true that the gastric
juice of the stomach, if abundant and strong, helps to
destroy  the poisons taken in drink,  especially if they
are in small quantities; but this is  only to a  limited 
CAUSES OF LIVER COMPLAINT.           65
extent,  as the gastric juice is not  always present in
the stomach to meet the water which may be taken.
  3. Climate.—The climates of the world vary.  Some
pinch us with  their cold, and if we live in them we must
spend  all our energies in  means  to protect ourselves
from the rigors of snow and ice.  Others are temperate,
and others are hot.  Now a cold and temperate climate
favors the healthful  action of the liver ;  while a hot cli-
mate, on the contrary, works on the liver, degenerating
its substance and lowering its action; and especially is
this so when  air and water act in  conjunction with cli-
mate.  These  are the principal natural causes that  pro-
duce liver disorders.
  We now come to consider those causes which relate to
individual peculiarities and habits, and  these are more
numerous than might be supposed.   Among them are:
  1. An  insufficient supply of  air  from unventilated
rooms, which  especially affects the sedentary and indoor
life of  those  who  devote themselves to  literature  or
any occupation within closed walls.
  2. Cramped positions  of the body, compressing  the
liver, and impeding the flow of blood through it.
  3. The want of sufficient exercise to  stir the blood
and keep it in motion in every part of the body.
  4. Tight clothing about the waist, and especially the
use of the corset, which impedes the circulation of  the
blood  in the  liver more than even  a stooping posture
does. 
66                   THE LIVER.
   5. Nervous excitement, and especially those  excesses
which  use up nervous  energy more rapidly than it is
generated, leaving the organs without stimuli to perform
their functions.   Especially to be enumerated are anx-
iety, mental emotion, worry,  fretting, sleeplessness, fear,
overworking of the  nervous system, and  quarreling—as
between friends, business partners, husband and  wife,
etc.
   6. Constitutional  peculiarities, as  a  tendency to dis-
ease of the liver inherited from parents by children.
   7. Poisons, and especially  poisonous  medicines given
during long-continued fevers, reducing the  system and
its vitality.
   8. Any disease that breaks down the health.
   9. Then again the  food we eat.   Only a few of the
human race eat as they should.  We are of opinion that
our unwise eating habits  have perhaps  more to do with
the wrong working  of the liver than  any other cause.
People pour into their stomachs whatever they like, and
wonder that they are not nourished.   Too much grease,
fat, oil, ham and eggs, hot  bread, superfine flour, salera-
tus, raised cakes, and so on  to the end of a long chap-
ter.
   10.  Intemperance.  Dr. Sewell says:  "Alcohol  in
every form and proportion produces a strong  and speedy
effect upon  this  organ when  used internally.  Its first
effect usually is to increase the action of  the liver, and
sometimes  to such  a degree as to result in   inflam- 
CAUSES OF LIVER  COMPLAINT
67
mation.  Its secretion  often  becomes  changed from a
bright yellow to  a green  or black,  and from  a thin
fluid  to a   substance  resembling  tar in  its consist-
ence ;  and  this  change not unfrequently leads  to the
formation of biliary calculi, or gall-stones.  There often
follows an enlargement of the organ and a change in its
structure.   Aware of these facts, the poultry dealers of
England are in  the habit of mixing a quantity of spirit
with  the food of  their fowls, in order  to increase the
size of the liver, that they may be enabled to supply the
epicure with a greater abundance of that part of the an-
imal which  he  regards as  the most delicious.   I have
met with cases in which the liver has become so far en-
larged from intemperance as to weigh  from eight  to
twelve pounds, instead of four or five, its usual weight.
The inflammation  of the  organ not unfrequently termi-
nates in suppuration and  the  formation of extensive
abscesses.   The liver sometimes, however, even when it
manifests upon  dissection  great organic change in  its
structure, is found  rather  diminished in  volume.   This
was the case in  the person of the celebrated tragedian,
George Frederick  Cook, who died several years since in
the city of  New York.  This  extraordinary man was
long  distinguished  for  the profligacy of his life,  as well
as the native vigor of his  mind and  body. At the time
of his death his body was opened by Dr. Hossack, who
found  that  the  liver, while it was rather diminished in
size, was in  a state of induration, and surprisingly hard, 
68
THE LIVER.
so as to make considerable  resistance to the knife; and
it was of a lighter color than natural.   The whole  sub-
stance of the organ was studded with tubercles, and the
blood-vessels,  which  are numerous  and  large  in the
healthy state, were nearly obliterated, showing that the
circulation had nearly ceased long before death.  I have
met with several cases, in the course of my dissections, in
which the liver had become shriveled and  indurated, its
blood-vessels diminished, and the organ greatly changed
in its structure;  the  evident consequence of  long-con-
tinued habits of intemperance."
  We have now given a brief list  of  some  causes of
liver disease.  In our next chapter we shall have some-
thing to say about the  best  methods of cure, and espe-
cially those methods  that  each  individual can apply
for himself, and which are eminently health-giving. 
THE CURE.
69
                 CHAPTER XII.
                     The Cure.
  We now come to an important chapter of our series on
the liver, and shall try to point out the best hygienic
means of curing derangements of this organ.   The first
statement we make is that much more can be done by a
careful regulation of the habits than by any other method,
and  the first thing to be attended to is the food.   Good
wholesome food, and the avoidance of deleterious articles
of diet will  accomplish more than all the drugs  in the
world.
  The things to be avoided are:
  1. Very highly-seasoned dishes.
  2. Hot and doughy bread and hot biscuit.
  3. Such vegetables  as  are not easily digested—pota-
toes, cabbages,  and the like.
  4. Alcoholic beverages,  and the use of tea and coffee
to any but a very moderate extent.
  5. The excessive use of sugar and oily foods.
  The varieties of  food that can be used to advantage
are:
  1. Good  home-made  stale bread.   The brown,  or
Graham, or unleavened, in the form of gems, is prefera-
ble, because it furnishes more nutrition, and also because 
70
THE LIVER.
it  keeps the bowels regular.   Baker's  bread will not
answer.
  2.  A moderate  allowance of fresh, lean  meat, espe-
cially mutton and beef, is admissible.
  3. Eggs may be  used occasionally, as  the appetite
craves them, but they should be  cooked for fifteen min-
utes in water at a temperature of 170 degrees, or put into
boiling water and then covered and set away from the fire
for fifteen minutes.   The object of this method of cook-
ing is to make the yelk hard, and leave the white of the
egg tender  and flocculent,  instead of solid.   An  egg
dropped on gem toast or nice brown bread toast is good.
  4. Fruit used properly is an almost certain panacea for
diseases of the liver.
  A sweet orange taken  before  breakfast is  sure to  be
relished, and should  not be  omitted where  it  can  be ob-
tained.   A mild, tart apple, eaten a  little before or after
breakfast, is  an  excellent pill for the liver in case  an
orange is not to be had.
  The grape in its perfection is one of the most delicious
of fruits, and in its season should form a prominent part
of at  least one meal each day;  but it should never  be
eaten  in an unripe condition,  as we generally find it in
market.  The best  way to use it is to eat it alive, fresh
from  the vines.   Go into the vineyard  and  select and
eat it  there, and  liver complaint will flee  away.   A very
nice meal may be made of ripe grapes and brown bread
and butter.   The grape should never be  eaten on the 
THE CURE.
71
top of a hearty dinner of soup, vegetables, and meat, nor
with pastry.   It  may be  eaten freely in the morning
and in the middle of the forenoon.  It is more of a drink
than food, and may be used as such.  The juice of the
grape flowing through the liver cleanses it of any clogged
material there contained.   Increasing the action of the
kidneys, it carries off through them such-poisons as have
been generated in the liver, thus acting as a true cleanser
cf the  blood.   Giving tone and health to the bowels, it
relieves the system through them of  offending  matter
that would otherwise cause much trouble.
   Another fruit for early  spring use which produces a
healthy action of the liver is the ripe strawberry.   It is
true, as it comes to the city, this fruit is not particularly
wholesome  unless  cooked; but  in the country,  where
it  can  be picked fresh and sweet from the vines, it
should, in  its  season, constitute  a  considerable portion
of the morning meal, eaten with bread,  toast, eggs, etc.
   The tomato is a liver pill better than any ever made
from calomel.  Many a poor sufferer with a torpid liver
has been  relieved by the tomato in its season.  Its acid
is very similar to that of the other fruits named, and it
produces  about the same effect.   This fruit may  be
eaten in almost any form  except green.   The tomato,
when fresh from the vine, is far better than after it has
been picked and become stale.  It may be taken before
breakfast, or  between  breakfast  and  dinner, with  or
without bread.  It should  not be mixed with other veg- 
72                  THE LIVER.
etables  if  the  best  results are to be obtained.   With
these fruits one may be quite sure to cure most of the
ordinary forms of disease of the liver if not too  far ad-
vanced.  It sometimes  happens  that the  stomach will
not tolerate fruit.   Where this is the case, a little man-
agement will suffice to quell  the disturbance of this un-
ruly organ.  Rarely will good fruit be found  to dis-
agree.  When fruit produces flatulence it is either unripe
or too sour.  Only perfectly ripe fruit will answer; any
other is injurious.   The tomato  sometimes proves  too
acid.  In this  case a  less  quantity  should be used.
Sometimes fruits lie too cold  on  the stomach.   In this
case some agreeable mild spice will help to correct the
evil.  Cinnamon is perhaps the best for the apple, and
a little pepper for the tomato.
                       DRINKS.
  We do not need  to say that there are a great variety
of mild  acid drinks which act very favorably on the liver;
indeed the  reason why mild acid fruits are so valuable is
on account of the fluids they contain.  Now, instead of eat-
ing the  fruit, nearly the same  benefit can be derived by
making delicious  and wholesome drinks from them and
using these quite freely.   When the stomach is weak and
delicate, and does not tolerate  fruit, then drinks may be
so made as to be very agreeable and refreshing.  Lemon-
ade and orangeade  and currantade may each be used
in its place and  season.  Other  fruit   drinks may be
made to suit the taste, season,  and climate.  See " Eating 
THE CURE.
'  73
for Strength," to obtain recipes for nearly one hundred
varieties.
                   '  FRESH AIR.
   Another excellent remedy for liver complaint is fresh
air.  This  is  so essential  that little progress can  be
made without it.  And by fresh air we mean pure, clean
air, free  from miasma, free from  the filth of poisonous
emanations, and free from dust and all kinds of  damp,
heavy vapor.  The air should be as highly ozonized as
possible  by  contact with green  trees and water.   In
order to get  plenty of fresh air, it is  necessary to pay
special  attention  to  ventilation of  both our day and
night apartments, and it is also desirable to live more or
less  out  of doors.  Out-of-door life, however, must  be
accompanied with some form  of  occupation which will
prove  pleasant  and  not very  taxing  to  the strength.
For  this reason fresh  air and  exercise should be com-
bined.  The following forms of outdoor exercise will be
found suitable:
   1. Horseback riding.  This is adapted to both sexes
and  almost  all ages.  It gives the liver just enough
motion to stir it and promote blood  circulation through
it.  A gentle, easy-going horse should be chosen for a
delicate person, and one that  can gallop for a person
who  enjoys galloping.   A  hard trotting horse should
be avoided.
   2.  Rowing is  a form of exercise which, when taken in
quiet waters  and  with a light  boat, is well  adapted  to 
74
THE LIVER.
make  the liver healthy  as  well  as  the  lungs  and
stomach.  Where it is available we would  by all means
recommend it to be followed persistently.
  3. Then there is also carriage riding, which is exceed-
ingly valuable, especially when  one drives his own horse,
with a pleasant, healthful country to view as he passes
along.   For  very delicate invalids,  carriage  riding  is
preferable to most forms of exercise, until the strength
permits more vigorous physical culture.
  4. There  are  other forms of outdoor exercise not to
be  forgotten.   Among these  are climbing  mountains,
making long  excursions  on foot,  botanizing, hunting,
fishing, gathering  specimens  of minerals,  etc., light
forms  of  agriculture  and horticulture, trimming grape-
vines, planting trees, gathering fruit, etc.
  5. While out-of-door exercises are advisable, there are
several forms  of indoor exercise very beneficial to those
whose  habits  are sedentary.  Among these are the lift-
ing-cure exercise, which has no superior, and will often
cure cases not  to be reached  by any other means;
exercises  on  the  family gymnasium,  especially those
that concentrate on the liver, such as bending the body
from side to side; also the wand and dumbbell exercises
of Dr.  Lewis's light gymnastics.  We cannot enumerate
the varieties here.  We may  especially commend  the
thrusting  of the wand from side to side as  far  as  the
hands  will carry it.
  In regard to sleep we would advise at least eight hours 
THE CURE.
75
every night.   Let the room be cool, but not cold, and
light and cheering in the day time; ventilate  it thor-
oughly ;  sleep with the head to the north; sleep alone
and go to bed early; rise early also, and take a little
light exercise before the morning meal;  but do no very
severe head-work late at night, either at reading or writ-
ing.  It  is desirable  that  persons with liver complaint
should cultivate  cheerfulness.  Their disease  tends to
lower  hope and produce  a, sort of misanthropy.  They
should strive against this, and keep company with cheer-
ful people, read funny books, and keep the mind occu-
pied with  elevating  subjects.  Do  not  let a day pass
without a hearty laugh.   When  the habit  of  cheerful-
ness is formed it becomes very easy to be cheerful.
   As regards bathing it should be practiced daily in a
warm room, using much friction on  the skin with the
hand.  At the same  time, the feet  should  be rubbed
thoroughly and well dried.   A sitz bath is useful for the
liver, especially  a warm one  at bedtime.  Let  the ab-
domen and sides be well kneaded after the bath is over.
   The Turkish bath  may be taken once a week to ad-
vantage if it  can be had.   Let a strong douche bath be
directed over the liver after the bath, and let the sham-
pooer rub  and knead the  bowels  and side gently, but
very thoroughly, as a part of the process.  After the bath
remain quiet till the next day.
   There is another method of treating chronic  invalids,
much in vogue in some places, which is very valuable. 
76
THE LIVER.
It consists in manipulating the entire body gently but
thoroughly for an hour or so once or twice a week, or
for half an hour more frequently.  It is a modification
of the movement cure, and  when well done is very in-
vigorating.  The attendant who does the work should
be  healthy  and  strong, and understand the  business.
This method is allied to the magnetic  method, and is in-
deed a part of it.  It is by far too little understood.
  Mineral waters are  much used  for liver complaint,
and are often very useful.  When taken  fresh from the
spring and of a mild character they are to  be commended
for many  persons, but too great reliance must not be
placed on them.   The system will not bear  them so
long as it will  more  strictly hygienic means.   In some
cases they work wonders, when combined with  the rest,
recreation, and scenery of a summer resort.
  Here we bring our subject  to a close, reserving a  few
pages in which to answer some questions which  may
touch  on  points  not  made  clear  in  the preceding
chapters. 
MISCELLANEOUS  QUESTIONS ANSWERED.       77
                 CHAPTER XIII.

        Miscellaneous Questions Answered.
          action of calomel on  the liver.
  Is it  true that calomel produces  any increase of the
secretion of bile from the liver, as the doctors  teach and
as is generally believed ?
  Ans.—No doubt  the teachings of medical  men  in
this  respect are  slowly changing, and that in  another
generation only a few will maintain that calomel acts on
the liver.   We are indebted for this  change to the skep-
ticism of  several scientific and practical physicians  in
England,  who, a few years ago, appointed a commission
to thoroughly investigate this  subject.   The report was
made by  Hughes  Bennett, M.D.,  celebrated  in two
continents for  his  great ability;  and it shows  con-
clusively,  we think, that  the  widespread belief in the
virtues  and the power of calomel to act on the liver is
only a fancy, a medical superstition.  The commission
found that in whatever form it was given, such as mod-
erate doses of blue pill, or frequently repeated doses of
calomel, or very large doses, it utterly failed  to act on
the  liver  or increase  the flow of bile,  and frequently
actually diminished it. 
73
THE LIVER.
   It is true  the experiments were made on dogs; but
there is no reason to think they would  be different if
made on men and women, for they found no more diffi-
culty in producing salivation in a dog than in a man.
   It was also found that the  secretion of bile was influ-
enced by the food, and especially increased after a glass
of water; and that beyond this and the maintenance of
health there  seemed to  be no  means of increasing the
flow of bile.   The importance  of  these observations in
refuting a widespread error is very great.
   It may be  asked, what is the effect of mercury on the
system, and the answer given is that it is simply a pur-
gative, and, so far as is now known, nothing more, unless
we add that it is a poison and  deteriorates the general
health.
   It may be useful to  know who originated this false be-
lief and practice.   We can  only  trace it back to old
Paracelsus, who lived and flourished  in the fifteenth
century, when  medicine was  conjectural and not sci-
entific.  The amount of harm he has done can never be
estimated.  The fact  shows us that an error, when it
gets  thorough foothold  on the mind, cannot  be  easily
eradicated.
  We may add that old Paracelsus,  though one of the
fathers of  medicine, was a genuine  old quack, gathering
most of his knowledge from  barbers, old women, con-
jurers, etc.  He made a great  reputation, in  his time,
with a quack medicine which he  called the " elixir of 
         MISCELLANEOUS QUESTIONS ANSWERED.       79

life," and with which he proposed to prolong life indefi-
nitely.
  Modern medical men have a great hatred of quackery,
but it is especially interesting  to  trace  some of their
practices back to their sources—the greatest quacks of
olden times.
                THOROUGH MASTICATION.
  Has rapidity  of eating anything  to do with causing
liver complaint and  indigestion?
  Ans.—It has  more to do in causing flatulence and  in-
digestion than in causing liver complaint.   Imperfect
mastication is the prime  cause  of much  dyspepsia, and
dyspepsia is  the cause of  many  diseases of the other  or-
gans of the body.  For this  reason it is exceedingly im-
portant that we chew our food thoroughly, and make it
so fine before it leaves the mouth that the stomach will
find its work half done when the  food reaches this  re-
ceptacle.   If the dyspeptic will  always do this he will
save himself much  suffering.  The benefits of thorough
mastication are these:
  1.  The food is made so fine that when it reaches  the
stomach this organ  is able to pour into it a large quan-
tity of gastric juice, and  this juice  mixes with the food.
as easily as if it were water.   If the food be not finelj
chewed, but  exists in lumps, the gastric juice  cannot  so
thoroughly become incorporated with it,  decomposition
takes place, and dyspepsia results. Let any dyspeptic try
the experiment of chewing every mouthful of food  till 
80                   THE LIVER.
it is as fluid as it can be made, and so find out for him-
self with how much greater ease digestion takes place.
  2. The second advantage of thorough mastication is
even more important than the first.   The saliva of the
mouth is, like the  gastric juice, a digestive fluid, and it
acts  on  the food  partly as a solvent and partly in con-
verting its starch  into  sugar.  Now it  is necessary, in
order that the saliva of the mouth may do its full work,
that it should be secreted in  large  quantities and thor-
oughly mixed  with the food.   This is perfectly accom-
plished by thorough mastication.
  Important as is thorough mastication it is not so easily
accomplished.  The force of habit, begun in childhood,
leads most people to swallow their food as soon as it
will  go down without causing pain.  Unless  special at-
tention is given to the subject, we forget and keep on
forgetting  till we grow old  and  die.   Those who are
victims to dyspepsia and liver complaint will be obliged
to make  special effort if they wish  to train themselves to
eat  slowly.
               HOW TO EAT AN APPLE.
  Many consider an apple unfit for dyspeptics, causing
flatulence and acidity.  Is this so, and if so is there any
remedy ?
  Ans.—There  is  no  fruit  more  serviceable  to  the
people than  the apple, not only  as a  luxury, but as a
wholesome, nutritious  food.   Apples   contain  sugar,
gum, much malic acid, and some valuable mineral mat- 
         MISCELLANEOUS QUESTIONS ANSWERED.       81

ter.  It is true that apples often produce indigestion and
flatulence, but generally the cause is to be found in the
manner in which they are eaten.  It may not be known,
but it is true, that an apple contains a great quantity of
fixed air, and, if eaten hastily, this air passes into the
stomach with the  pulp before  it is liberated.   In the
stomach it becomes heated, expands, and causes flatu-
lence in persons with weak  digestion.  Such  persons
should  choose  a fresh, mild,  tart apple, with a silver-
bladed knife peel off the skin, and then scrape the apple
to a fine pulp; now place it in the mouth and thoroughly
mix it with saliva before  swallowing it.  This is very
important.   It may be placed on a thin slice of bread
and eaten with it.  If it is too troublesome to scrape the
apple, then  it should be chewed till every cell is broken
down and  the  air  liberated.  Many believe apples are
more wholesome if taken in  the morning.  If this be
true, it  is only because  then the stomach is more vigor-
ous.  Thousands of the Swiss peasants make their entire
supper  on apples  and bread, and  thus  preserve good
health and nourish their bodies well.
   Physiologically,  the apple acts as  a stomachic by pro-
moting  digestion,  and when taken in  the morning it
becomes a  laxative.  Its action on the liver is favorable
to the health of this organ.  It also corrects the  evils
of too much and too highly concentrated food.
                        MILK.
   May  a person with liver complaint use milk ? 
82                  THE LIVER.
  Ans.—This must be determined by individual experi-
ence.  Some stomachs will not bear milk, others will.
  When used it is generally better to take it with some
other food rather than as a drink.
  When drunk alone it coagulates  in the stomach as a
solid  mass,  which becomes hard like curd, and  is not
easily dissolved; but when mixed with the food, it enters
the stomach in a state of greater  division,  and coagu-
lates in smaller and  more floculent pieces,  and is more
easily  digested.
                 PATE  DE FOIE GRAS.
  Is pate de foie gras made from  healthy or diseased
livers ?
  Ans.—From diseased livers, the product  of  stuffing,
quiet, and warmth.   These  diseased livers are unwhole-
some when  used as  food.   Epicures, who are of little
use in the  world, may not be particularly injured  by
them, for nothing will  make a rotten  egg any  worse
than it is.
                 CONTRACTED  LIVER.
  What is the cause  of a contracted liver ?
  Ans.—Usually it is the result of intemperance.   Anat-
omists call a contracted liver the " gin drinker's liver."
                  SPIRIT DRINKING.
  Why does spirit drinking injure the liver?
  Ans.—If  you will read  the  chapter  of this book
which shows how the blood  circulates in this organ, vou
will  see  that  alcoholic drinks  pass  from the  stomach 
         MISCELLANEOUS QUESTIONS ANSWERED.       83

chiefly into the portal circulation, and immediately into
and through the liver.  It is the immediate presence of
so much alcohol in the liver that does the harm.   Those
who take their alcoholic  drinks only after  eating are
less injured in the liver, because the drink is mixed with
the food, and much of it diverted into other channels.
                     GALL-STONES.
   Why does a gall-stone occasion so much pain ?
   Ans.—A large gall-stone may exist and give no pain
if it remains stationary.  But the moment nature tries to
force it out, it  carries it into the gall-duct, a small pas-
sage  about as large  as a goose quill, and the sharp cor-
ners of the  stone, pressing on the sides of the duct, lac-
erate or inflame the part, and cause the pain.
                       JAUNDICE.
   Why  does a person with jaundice often  see things
yellow ?
   Ans.—Because  the humors  of  the eye  are  tinged
yellow, which makes everything appear as if seen through
a yellow glass.
                    CURE OF JAUNDICE.
   Are there any hints especially useful to  a jaundiced
person ?
   Ans.—Drink  plenty of pure, soft water,  eat brown
bread  and   fruit,  take plenty  of  wholesome  amuse-
ment, especially of a kind calculated to divert the mind.
Exercise as  much as is agreeable.   Live in pure, fresh
air.  Sleep  much and take  a warm bath  daily, using 
84                   THE LIVER.
much friction after  the bath.  The wet-sheet bath is es-
pecially useful, and so is the Turkish bath.
               HYDATIDS IN  THE LIVER.
  What is a hydated tumor of the liver ?
  Ans.—Hydated  tumors are  immature  tape-worms
which gain  access to the liver,  in the egg, through our
food and drink.   It is a rare  disease among cleanly peo-
ple, but very  common in Iceland.  Whoever has a hy-
dated tumor is very unfortunate,  and will not get off
without much suffering and perhaps death.
                     BILLIOUSNESS.
  What is the true meaning of the term " billious."
  Ans.—Generally when a person says he is billious, he
means that his liver does not behave itself properly ; but,
in nine cases out of ten, the trouble  is in the stomach
and bowels,  which have been clogged up and obstructed.
The  true  remedy is  to  secure  a  healthy action  of the
bowels daily.  This will carry off the foulness, and give
relief.   One  reason why calomel seems to give relief to
billiousness is because it forces away this offending mat-
ter in copious evacuations.  How much better to main-
tain healthful  evacuations by  suitable food !
                  DANDELION GREENS.
  Do dandelion greens act on the liver?
  Ans.—A tolerably harmless purgative for the  bowels
is taxaracum, which is  extracted from the dandelion;
but this vegetable may be eaten  as a food and  all its
good effects obtained.   The freshly expressed juice of 
         MISCELLANEOUS QUESTIONS ANSWERED.       85

the herb may be used if  thought best.   It is not poi-
sonous, but  more  a food  than a medicine.  It is much
better to secure in our food those qualities we seek in
medicine than to go to the druggist for them.
                  PAIN IN THE SIDE.
   Does pain in the side indicate liver complaint?
   Ans.—The sideache may have several causes, as rheu-
matism, inflammation or congestion of the liver, spleen,
or lungs.   If the pain be in the upper part of the chest,
it is probably from the lungs.  If on the right side, low
down, then probably  the liver is the cause,  and if on
the left side, it may be the spleen.  It may be caused by
sedentary  habits,  exhaustion,  or   sprain.   The  best
remedies are the warm bath, with friction and moderate,
gentle exercise, and the very best physical training of the
parts affected.
         SINKING  AT THE PIT OF THE  STOMACH.
   What is  the  cause  of  the  sinking  at the  pit of the
stomach, the all-gone feeling  so often experienced, just
as if the stomach were entirely absent ?
   Ans—It is a popular  expression  for  a nervous  sen-
sation indicating  impaired digestion  and exhaustion of
nervous force.   It requires   constitutional  treatment,
regularity of meals, moderate  and slow eating of whole-
some food,  and the absence of tea drinking or taking of
alcohol on an empty stomach.   The application of elec-
tricity over the  region of the  stomach and  bowels will
often prove very beneficial. 
86                   THE  LIVER.
                   WARM CLIMATE.
  How shall one who removes  from a cool  to  a warm
climate avoid liver complaint ?
  Ans.—By obeying all the laws of health as far as pos-
sible, and by paying special attention to the water used
for drink, and the  food eaten.   In a hot climate, avoid
the fats and substitute fruits as far as can be done.
MAGNETIC TREATMENT  OF  LIVER  COMPLAINT, HEADACHE,
                   AND DYSPEPSIA.
  Much  is said of magnetism for curing disease.  Are
there any simple rules for treating  magnetically liver
complaint, headache, and dyspepsia ?
  Ans.—Dr. Babbitt,  a well-known  and  conscientious
magnetist, has prepared the following rules in answer to
this question:
  1. Hold the hand for some time over the right side, on
or below the lower ribs.   This may be  done while still
in bed at night or in the morning.  The arms, joining
the body near  the  brain-battery, communicate a strong
tide of magnetic life to the hands, and especially to  the
ends of the fingers, through  the brachial nerves.  The
hand thus held will be very apt to start a perspiration,
after a brief time, and to arouse the extra  magnetic ac-
tion, which will cause a more active flow of blood to the
parts.
  2. Rubbing briskly over the  same place is very fine
practice, as it wakens  the frictional electricity, and also
communicates the warm magnetism of the hand. 
         MISCELLANEOUS QUESTIONS ANSWERED.       87

  3. Kneading, rocking, and pressing the right side will
tend to prevent the blood  from congesting in the liver,
and, moving  it like water  in  a squeezed sponge, will
hasten it onward toward its destination.
  4. Gentle  strokes over the parts will  also  arouse ac-
tion.   A very good plan is to place one  hand over the
liver and strike on it with the other hand.
  5. It is well to rub  across the whole body from right
to left and  from  left to right for some time, to arouse
the liver, stomach, spleen, and  the other  connecting or-
gans.  The pit of the  stomach, which, with its plexuses
and ganglia, is really the capital of the visceral system,
sometimes becomes overheated  and irritated,  and  draws
the life force  away from the liver, which, by this wide
sweep of the hand, is brought back again, while the epi-
gastrium itself is brought into better balance.  If this
arouses the bile so as to cause nausea  or  restlessness for
a time it is  all  right  and desirable, and will lead to
triumph at last.
  For an inflamed or  irritated condition of the liver
{hepatitis), hold the hand over it for  a moment, then
pass it outward to draw away the heat.  Make a number
of passes outward, especially toward the back and sides.
To dip the  fingers in cool water while doing this will be
found  useful in cooling the parts.
         MAGNETIC TREATMENT  FOR DYSPEPSIA.
  1. Get the liver in proper condition, as above.
  2. If the stomach be sluggish, rub thoroughly over the 
88
THE LIVER.
parts until a warm glow  is communicated.  At times,
especially  mornings and nights  while in bed, let the
hands rest there for some time,  especially over the epi-
gastrium.  To knead and rock the parts daily will often
hasten the food  in its  progress  to chyme  and chyle,
before it has  stood long enough to ferment and  form
gases.  If costiveness  prevails,  rock  and  knead the
bowels, and especially make a large circle over the whole
outside of  the viscera, moving upward on the right side,
across over the hypochondriac region—which includes
liver, stomach, and  spleen—and downward on  the left
side.   In this way you will follow  the ascending  and
descending colon, assist the  movement of the feces, and
help vitalize the liver, etc., all of which have much to do
with  the proper  action  of  the bowels.  A magnetic
physician  of  Chicago could  get  up immediate action
of the bowels by manipulation, and challenged the reg-
ular physicians to excite an action by the most powerful
drugs  as quickly as he  could with his hands.  I have
often accomplished this loosening action myself; and
some persons, who have  thus  been made to have three
passages  a  day, have felt strong and buoyant, instead of
being prostrated  or weakened, and  followed with  still
greater constriction, as is apt to be the case with drugs.
Although  automany or self-manipulation may not be
quite so  effective as  the hands of another person, es-
pecially one who is well charged with the magnetic aura,
yet many  unprofessional persons, after a  little experi- 
         MISCELLANEOUS QUESTIONS  ANSWERED.       89

ence,  accomplish wonders  on themselves and  families.
A young man lately informed me that, since  seeing my
simple process of relieving costiveness in my " Health
Guide," he can  start an action  on himself any time  in
fifteen minutes; and a Mr.  J.  H. Mendenhall, of  In-
diana, by following the same rules,  saved the life of his
daughter, after eminent physicians had said she must die
in forty-eight hours, and after she had become insane by
having her bowels constricted for two  weeks, and by
having received a  thousand doses of  medicine.   He
entirely cured her  by means of these fine  life  forces,
after  the coarser drug elements had  brought on  par-
alysis, costiveness, and insanity.
  For irritation  or  overheat of the stomach, place the
hand  over  the pit  of the  stomach, and  make outward
passes in various  directions  to conduct  away the heat.
The effect will often  be good to put the  fingers in pure
water or in water with a little salt in it.  Heating foods
and all stimulants should be avoided.  When the pit of
the stomach feels tender to the  pressure, or  when there
is much of a burning sensation,  it betokens  this  heated
condition.   If not  restrained, it tends very much to a
passion for alcoholic  beverages.   I have broken up the
appetite  for liquor, in a number of cases, by making
these  passes  across the stomach, and especially by mak-
ing the outward passes and  drawing off the gastric in-
flammation, manipulating the feet, and  toning up  and
equalizing  the system generally.   Wetting the fingers 
90                   THE LIVER.
in cool water, and passing  them down in front of the
ears, toward the shoulders, will modify the heat action
of the pneumogastric nerve.
                 NERVOUS  HEADACHE.
   Psychomancy, or, in other words, manipulation, is en-
tirely unequaled for curing  headache.   Press the right
hand on the forehead, the left hand on the back of the
neck, and hold them there awhile. Make passes down the
back of the head and neck, and along down the arms and
spine, to draw the heat away from the cerebrum.  Cool
water should be  put on the top of the head and temples,
but not on the back of the head.  For neuralgic head-
ache, hot water is generally the best for the forehead and
temporal regions, although  cool, wet fingers placed in
front of the ear, at the root of the  trifacial nerve, will
often  subdue  the  neuralgic pains  like magic.   In this
case, hold the right  or positive  hand on the right side
of the head, and the left on the left side.
  In the case of sick headache treat the head and also
the liver, stomach, etc., in the manner already described,
bringing about a general  equilibrium.
             ELECTRICITY FOR  THE LIVER.
  Is electricity of  any value in the home treatment of
liver complaint ?
  Ans.—Electricity is an excellent tonic, and, to those
persons  with  whom it agrees, especially serviceable in
toning up and giving strength to the system, and through
that to the liver.  Applied  also  directly to this organ it 
         MISCELLANEOUS QUESTIONS ANSWERED.       91

will  often  temporarily relieve  congestion.  If a person
intends to use it on his person, he should secure one of
Dr. Kidder's machines, costing about twenty-five dollars,
and, in addition, a manual of treatment, and learn how to
apply  it,  beginning gently, and  continuing  the treat-
ment from  a  quarter to a half  hour daily, as  seems
agreeable.   Be  careful not to take  too much at first.
In case you can take a few lessons from  some one  ac-
quainted with its use do  so.   As a  promoter of  sleep
electricity is excellent, if taken at bedtime.   If  a tonic
effect be desired, take it in the morning on rising.  It
should not be taken more than once a day.
             DISPLACEMENT OF THE LIVER.
  Does the liver ever become displaced, and how \
  Ans.—The liver does frequently become  displaced,
and  mainly in  those cases where tight lacing is  prac-
ticed.   It may also  occur in men who wear  a tight belt
about the waist  over the  liver.   Pressure over the liver
should  never  be allowed.  It hinders the flow of blood
in the organ, and, beside displacing it, causes congestion
and  enlargement.
                  PAIN IN THE LIVER.
  What causes pain in the liver ?
  Ans.—1. Obstruction of the gall-duct, which prevents
the flow of bile.  This damming up of the bile reacts on
the  liver, causing fullness, oppression, and a dull, heavy
pain.
  2. Gall-stones are also a cause of pain, and any person 
92                   THE  LIVER.
who has them should  be careful not to  ever exercise or
take any violent strain, as this may force the stones into
the duct, and bring on intense suffering.
  3. Another cause  of pain may be ulceration.  This,
however, is not so common.
  4. Neuralgia may be the cause of pain in the liver.
This is very rare.  One of the best applications for pain
in the liver is hot wet  compresses changed frequently,
and applied for an hour each day, or oftener if required.
                   WATER DRINKING.
  What effect has water drinking on the liver ?
  Ans.—If taken on an empty stomach  early in the
morning, half an hour before eating,  it promotes the
flow of bile and helps to make the liver healthy.  It is
a good  practice to do this.   The water should be pure
and soft, of a suitable temperature, and taken in such
quantities as are agreeable.  A  glass is not too much
for a person  in  full  health.   Very old people should
have  the water  hot  and  mixed  with  milk, and take
less.
                  THE LIFTING CURE.
  Is the  lifting cure  adapted to diseases of the liver, to
dyspepsia, and to headache ?
  Dr. L. G. Janes writes us as follows  on  this subject:
A practice of ten years in  the  application of the  lifting
cure, in diseases and disorders of the liver and digestive
organs, enables  us to  testify to  its great  value as a
remedy in these affections.  It has an almost immediate 
         MISCELLANEOUS QUESTIONS ANSWERED.      93

effect in promoting the secretions, and aiding in the ex-
cretion of  waste material from the system.  These re-
sults are in part due  to  the  powerful  stimulating and
equalizing property of the lifting exercise upon the gen-
eral circulation of the blood, which compels a healthful
action through all the tissues of the body, where the cir-
culation has become torpid through inactivity; and in
part due to the direct mechanical compression of the
organs, through the pressure by contraction of their sur-
rounding muscular walls.  The effect is thus both gen-
eral and local; general, resulting from the uniform con-
traction of all the muscular tissues, thereby stimulating
and  equalizing* the circulation throughout  the entire
body; and local, resulting from the mechanical pressure
upon the torpid or diseased  organs.  It thus forces out
effete matter—the potent cause of irritation, ulceration,
and*disease—from the system, and  makes all the excre-
tions more free.  It promotes quickly and certainly the
peristaltic  movement  of  the  bowels, thereby removing
constipation.  By increasing  the  activity  of the  cir-
culation throughout the digestive  organs, it renders as-
similation more perfect, the body becomes  better nour-
ished, and  the new tissues formed  are  of an improved
quality.  The tissues and internal coating of the stomach
and   bowels  are thus   improved in  tone,  and  their
functions  are consequently more perfectly performed.
Through the  equalization of  the circulation it tends to
relieve congestion of the liver, and to  allay  all inflam- 
94
THE LIVER.
mations.  By removing obstructions  and congestions,
expelling  effete  material, and strengthening  and equal-
izing the nervous forces, it is most effective in  relieving
headaches which arise from indigestion  or  disordered
nervous action.   Many  persons  have been  benefited
who were subject  to  periodical or  sick  headaches, by
the gradual  amelioration of their predisposing causes.
The number of cases of torpid, disordered, or diseased
liver, indigestion, dyspepsia, in its protean forms, consti-
pation,  heartburn, flatulence,  and  headache,  caused
wholly  or in part by these  derangements, which have
been relieved and removed by the  lifting cure, is very
great;  nor do we recollect of any case where  a  fair trial
has  failed to produce   beneficial  results,  which  the
patient  had  often failed  to derive through  ordinary
hygienic or medical treatment. 
     INFLUENCE OF


MENTAL CULTIVATION


        IN PRODUCING



    DYSPEPSIA.

           BY
                       !

      A. BKIGHAM, M.D.



        THIRD EDITION.
    NEW YORK:
M. L. HOLBROOK & CO.
     1878. 
 
INFLUENCE  OF MENTAL  CULTIVATION IN
           PRODUCING  DYSPEPSIA.
  Dyspepsia is generally considered  a disease of the
stomach primarily; but I apprehend that, in a majority
of cases, especially among students, it  is a disease of
the brain p,nd nervous system, and is perpetuated by
mental excitement.
  Among the reasons I have  for  this opinion,  inde-
pendent of my own experience, are the following:
  1. A blow or other injury of the  head, or a tumor in
the brain, frequently produces sickness, irritation of the
stomach, and all trie symptoms of dyspepsia.
  2. " Dyspepsia  may be produced by mental  affec-
tions," says  Dr. Parry, and in  this  opinion  he is  sup-
ported by numerous observers.  "Who is there that has
not felt the  influence  of bad news or  mental agitation
in destroying the appetite and  deranging digestion, and
thus producing dyspepsia for a short  time ?
  3. Insanity, or disease of the brain, is usually pre-
ceded  by the symptoms  of  dyspepsia,  and recovery
from mental derangement is often marked by a return
of these symptoms.
  During the paroxysm or continuance of insanity, the 
98       INFLUENCE OF MENTAL CULTIVATION

brain alone appears affected; but, at other times, when
the brain is  relieved  the  stomach is affected.  I am
aware that Broussais  and others say that in such  cases
the disorder of the stomach is the primary affection, and
is  truly  chronic inflammation  of  the stomach, which,
after continuing a considerable time, stimulates the brain
until madness is produced.   But the same able  observer
says that the insanity is  preceded  by  long-continued
hypochondriasis and other nervous affections,  which I
suppose to arise from disease of the brain, and not of the
stomach, as he affirms.  He refers to instances of  mel-
ancholy from nostolgia, unrequited love, loss of fortune,
mortified pride,  etc.;  but  which  did not  terminate in
insanity  until  after  long-continued  disorder of  the
stomach.  He supposes that in such  cases the violence
of the reaction from the disease of the stomach produced
insanity; but to me it appears  more rational to suppose
that the irritation of the brain, produced by the moral
cause, not  only caused  the  disorder of the  digestive
organs, but, by its continuance, increased the disease of
the brain to such a degree as to cause mental  derange-
ment; just as we see a blow  on the head produce at
first only slight sickness of the stomach and vomiting,
but afterward violent delirium.   From the cases which
Broussais has given, it evidently appears that  slight
irritation of the brain, from mental or other causes, gives
rise  to  derangement of the stomach, and produces the
ordinary symptoms of dyspepsia. 
IN PRODUCING DYSPEPSIA.
99
  I very much doubt whether sick headache  as  often
arises from disordered stomach as from irritated brain.
I have repeatedly noticed an attack of sick headache
after  indulging  in stimulating food and  drinks in the
evening; but I have  known the headache prevented by
keeping the head cool after an evening's debauch.
  Dr. James Johnson says that Mr. "Weeks, of Jamaica,
when intoxicated, always went to sleep with his head in
cold water in order to prevent headache;  and it is a
common practice in India and some other places, after
drinking what is called a mosquito dose of  brandy,  to
sleep with the head on a wet pillow, and thus subsequent
headache is  prevented.  I have known  this practice
resorted  to, and with like effect.   But if the pain of the
head be caused by indigestion, what possible efficacy can
there be in keeping  the head cool?  I conceive, how-
ever, that the increased action of the blood-vessels during
sleep, produced by the stimulating food or liquor, deter-
mines an unusual quantity of blood to the brain, irritating
it, and this irritation  of the brain produces the  pain of
the head, sickness, and disorder of the stomach.  I have
noticed,  moreover, that  this  disease  most  frequently
affects those whose nervous  systems  are delicate and
easily excited; and I  have often  known it  produced by
grief or  great mental excitement, and it is  seldom re-
lieved without rest or long abstinence.
  4. Examination of the bodies of those who have died,
after  long-continued dyspeptic symptoms,  confirms the 
100       INFLUENCE OF MENTAL CULTIVATION

opinion I have advanced, that dyspepsia is often a disease
of the head, and not of the stomach.   Dr. Abercrombie,
in " Organic Diseases of the Brain," says, that " symp-
toms which really depend  upon disease of the brain are
very apt to be referred to the stomach.*'  After men-
tioning several  cases, in  which  for  a long  time the
prominent symptoms  were those of dyspepsia,  and in
which  no trace of organic disease of the stomach was
discovered after death, but tumors or  other disease of
the brain, he says : " Many other cases of organic disease
of the  brain are on record, in which  the only morbid
appearances were in the head, though  some of the most
prominent symptoms  had been in the stomach.   Some
of these resembled what has been called sick headache;
others  were chiefly distinguished  by remarkable distur-
bances of the digestive functions."  Dr. Abercrombie adds
this important caution : "In  cases of  this class we must
beware of being misled in regard to the nature of the com-
plaint, by observing that the symptoms in the stomach are
alleviated by attention to regimen, or by treatment direct-
ed to the stomach itself.  If digestion be impeded, from
whatever cause, these uneasy  symptoms in the stomach
may be alleviated by great attention to diet;  but no in-
ference can be drawn  from this source in regard to the
cause of the derangement."
  This  last quotation  I think explains a very common
mistake—a mistake which is not only made by dyspep-
tics themselves,  but by writers on this disease.   They 
IN PRODUCING DYSPEPSIA.
101
suppose because  low diet,  etc.,  relieves  the principal
symptoms in the  stomach, that therefore  the disease  is
confined to that organ; when, in fact, the disease is in the
head, but is manifested  only by the  stomach, the liver,
or some organ with which the brain sympathizes, and
the low diet gives relief by lessening the  too energetic
action of the brain.
  Dr.  Burrows relates the case of a lady who had been
unwell for several years.  She referred all her sufferings
to the stomach, and often said that when  she was dead
there would be found the  seat of her disorder.   She
died rather suddenly with fever  and delirium, after ex-
posure on a very hot day;  and on examining the  body
no trace of  disease  appeared in the stomach  or bowels,
but the brain exhibited marks of long-standing disease.
  5. The fact that dyspepsia is frequently cured by per-
mitting the overtasked  and tired  brain  to  rest, or by
changing  the  menial labor or excitement, is evidence
that it is primarily a disease of the head, and not of the
stomach.  How often  do physicians fail  to  afford any
relief by medicines  in  what are called " stomach affec-
tions," but  which are  readily cured  by traveling, or
relaxation in accustomed studies, and freedom from care
and anxiety !  How often a change in the mental excite-
ment affords relief! It seems as  if certain portions of
the brain, having been unduly excited, became diseased,
and were  benefited  by strong excitement  of  other  por-
tions of the  same organ.  How often are stomach affec- 
102      INFLUENCE OF MENTAL CULTIVATION

tions cured by inert medicines, aided by the imagination,
confidence, hope, etc.!
  6. The fact that dyspepsia is a disease chiefly confined
to the studious, to those whose minds are much exercised
and excited, and to those who, by too early mental edu-
cation, have had a predominance  given  to  the nervous
system, is evidence that the brain is the  primary organ
affected.  I know it is said that the sedentary habits of
students cause this disease, and no doubt exercise is neces-
sary to preserve their health; but it proves beneficial
by  changing  the  circulation and  diverting the blood
from the head.  If they studied less, exercise would not
be so necessary.  I have not observed that tailors, shoe-
makers,  etc., are particularly liable  to  dyspepsia.  It
often  happens that men who commence study late  in
life, after having been engaged for years in  some labor-
ious employment, become in a short time dyspeptic.  I
conceive that this arises from too  severe  labor imposed
upon the brain.  This organ should be gradually exer-
cised in order to develop it properly, and fit  it for severe
labor without injury.
  It is often  said that intoxicating liquors produce this
disease;  but I have  been astonished  to  see how many
drunkards are free from it.
  Good  living is said to cause dyspepsia; but the most
healthy people I have  ever known have been among
those  who lived well—who ate freely several times a
day of  the most nutritious food.  By some  it is  said 
IN PRODUCING  DYSPEPSIA.
103
that tobacco, snuff,  tea, coffee, butter, and even bread
cause this complaint; but whoever will make inquiries
on this subject throughout the community will find that
this is seldom true.  In  fact dyspepsia prevails, accord-
ing to my  experience, altogether  the  most among the
temperate and careful—among those who are careful as
regards what they eat and drink, and the labor they put
upon the stomach; but exceedingly careless how much
labor they put upon that more delicate organ, the brain.
Such people often eat nothing but by  the advice of the
doctor, or some treatise on dyspepsia, or by weight; nor
drink anything that is not certainly harmless; they chew
every mouthful  until  they are confident, on  mature
reflection, that it cannot hurt the stomach.   Why, then,
are they dyspeptics ? Because, with all  their carefulness,
they pay no attention to the excitement of the brain.
They continue to write two or three sermons or essays
every week, besides reading a volume or two, with  mag-
azines, reviews, newspapers, etc., and attending to much
other business calculated to excite the mind.
  To me it is not strange that such  persons have nervous
and  stomachic affections.  The  constant excitement of
the brain sends an  excess of blood to the  head, and
therefore other organs are weakened, and morbid sensi-
bility is produced, which renders the stomach liable to
derangement from very slight causes.
  " I tell you honestly what I think," says  Dr. Aber-
nethy, " is the cause of the complicated maladies of the 
104:       INFLUENCE OF MENTAL CULTIVATION

human race; it is the gormandizing  and stuffing,  and
stimulating their organs (the digestive) to excess, thereby
producing nervous  disorders and irritations.  The state
of their minds is another grand cause; the fidgeting and
discontenting themselves about what cannot be helped;
passions of all kinds—malignant passions pressing upon
the mind—disturb  the  cerebral action and do much
harm."
  This statement should be reversed, I think.  It is the
fidgeting  and discontenting  ourselves  that  make  the
gormandizing so dangerous.  I  do not mean, however, to
approve of gormandizing;  and I know that people in
this  country generally  eat more than is  necessary.
Still I do not believe that good nourishment, and abun-
dance of it, cause  many of  the diseases that flesh is heir
to.   Nations that are best  supplied with food are the
most  healthy, live  the  longest, and have most vigor
of body  and  mind.  Children, especially,  should  be
well nourished.  Good diet is an essential part of good
education.   The method of rearing children which some
propose—and  which I fear some adopt—of  restricting
them to  very light food that  contains  but little nour-
ishment,  is  very  reprehensible.  Every farmer knows
that such a course would stint  and ruin his cattle, and it
will as assuredly have such an  effect on children.  The
way to make children  thrive  and  do  well  is  to give
them plenty of good food, and keep their minds free
from anxiety and chagrin. 
IN PRODUCING DYSPEPSIA.
105
  Insufficient  nutriment weakens the mind as well  as
the body.  Many writers place poor diet at the head of
the causes that weaken attention and  debilitate all the
faculties of  the  mind.  Thus we often see  that disease
which wastes the body enfeebles the mind also ; though
this is not always the case, for sometimes the brain does
not diminish as the other parts of the body do.
  But to return to the causes of dyspepsia.   We do not
find this disease prevalent in countries where the people
eat most enormously.   Travelers in Siberia say that the
people there often  eat forty pounds of food in one day.
Admiral Saritchaff saw a Siberian eat immediately after
breakfast twenty-five pounds  of boiled rice, with three
pounds  of butter.   But dyspepsia is not a common dis-
ease in Siberia.  We do not learn  from Captain Parry
or Captain Lyon that their  friends, the Esquimaux, are
very nervous and dyspeptic,  though they individually eat
ten or twelve pounds of solid food in a day, washing it
down with a gallon or so of train oil.   Captain Lyon
was, to  be sure, a little concerned  for a delicate young
lady Esquimaux who ate his candles, wick  and all; yet
he does not  allude to her inability to digest them.
  The influence of  the mind  in producing disease ap-
pears  to be but little regarded in practice, though there
are few who will not acknowledge  that this influence is
great.   Plutarch says, in  one  of his essays, "Should the
body sue  the  mind  before  the court of judicature  for
damages, it  would be found that  the mind would  prove 
106       INFLUENCE  OF MENTAL CULTIVATION
to have been a ruinous  tenant  to its landlord."   The
truth of this mankind will the more  realize as they be-
come more intellectual, unless great  care  be taken to
develop and exercise the organs of the body equally and
properly.
  It is true, however, that the regular application of the
mind to severe but calm study and inquiry is not very
apt to affect the  health unfavorably.  The  illustrious
Kant, who lived  and studied to  a great age, says  that
" Intellectual pursuits tend to prolong life."
  But studies that  strongly  excite  the  feelings  or
awaken the passions are very apt to  injure the health;
and  it is  probably true  that the literary men in  this
country are generally engaged in the strife of party and
sects, and consequently their  studies  are not  always
those of  calm inquiry.  But  the  excitement of  the
mind,  produced   by   the  numerous   stirring  inci-
dents of the times, tends to increase disease, and es-
pecially nervous  diseases, among all  classes  of  peo-
ple.   A  violent  election increases  disorders of  the
digestive organs;  and  a " difficulty in the parish,"  a
phrase well understood in New England,  often multi-
plies them.
  Finally, if dyspepsia be a disease of the stomach, why
is it not more frequently cured by attention to diet than
it is ?  I know that by this method some are relieved,
and I also know that those disposed to dyspeptic disease
will not be able to continue their severe studies if they 
IN PRODUCING DYSPEPSIA.
107
are not careful as respects diet.  For if the vital energy
be all directed to the brain, and consumed by the act of
thought, the stomach will not be  able to digest much
food.  If, however they  study but little,  they can eat
more with impunity.  I  have  not, however, known this
disease cured by a change of diet alone.  I have known
many students and professional gentlemen who were af-
flicted with troublesome stomach  affections for several
years,  during which time they frequently believed they
had discovered  a remedy for  their evils.  Sometimes
they were to be cured by eating  bran bread ;  at others,
by weighing all the  food they ate, or by living  on rice
or  porridge, or  by  living without coffee  or tea, or
by  some  trifling change in diet,  about  as important
as  putting a few grains, more  or less, of salt in  an
egg-
  Most of these  methods afford some relief for a while,
and this is usually in proportion to the confidence with
which  they are imposed or embraced; but I do  not
know of one solitary cure by any of these means alone.
  The best instances of cure which I recollect have
been in those individuals whose minds have been per-
mitted to rest  from  accustomed labors, or have been
directed to new pursuits, or relieved  from anxiety and
care.   Some have traveled  far, and  have  recovered;
voyages have restored others.  Some  have become hus-
bands, and forgotten  their stomach complaints; some
have succeeded in business, and are well;  some are in 
108       INFLUENCE OF MENTAL CULTIVATION
 or  out  of office,  and thus their  minds are freed from
 long-continued anxiety; while others  remain  as  they
 were several  years  since, having just discovered, for
 the  twentieth time,  some new  and, as  they  believe,
 effectual remedy for  their indigestion; but which will
 assuredly disappoint  them  if they  do not cease from
 mental  toil, and for  a while let the excited  brain  be
 quiet.
  These views respecting stomach affections so common
 among the students of this country, will to many appear
 strange, perhaps absurd; but  to  some I trust they will
 be useful.  I feel  confident they will be, if they induce
 those who are worn down by  mental labor and anxiety,
 connected with long-continued disorder of the digestive
 organs,  to throw  aside their bitters, blue  pills, mustard
 seed, etc., and seek  bodily health and future  mental
vigor in judicious exertion of the  body, innocent amuse-
ments, cheerful company, ordinary  diet,  and  mental
relaxation. 
HEADACHE. 
I 
HEADACHE.
  The minor ills of life are the occasion, after all, of far
more real suffering than is generally supposed.   Tooth-
ache, which excites no alarm, will  drive the strongest
man  wild.  A little boil will do the  same thing.   A
speck in the eye will so annoy a healthy man that he can
do nothing till it is removed.  A sliver under the nail
will ache and  divert the mind from all feelings of kind-
ness for hours, perhaps  for days.   Very  great is the
amount of pain suffered in this world by those who are
never sick.   It is the little things of life that, after all,
wear on us and often wear us  out.  The  great trials
come on us with such tremendous power that we at once
succumb and  try to make the best of them.  Headache
is one of those little things that cause a great  deal of
suffering.  It  is one of the minor ills of life that cause
unrest,  and wrinkle the brow with  care, anxiety, and
pain.   Who has not had the  headache ?  Only the very
few whom  fortune  has favored.   The  author. of these
lines is one of the few.  He cannot picture in all its full-
ness the feelings of those who  have been differently
favored.  It is only as he  has  heard  described by
others their suffering that  he can know  anything about
it.  He  believes that  much of the headache  which 
112
HEADACHE.
afflicts poor suffering mortals might be avoided.  What
cannot be avoided might be modified and made less se-
vere, and thus  any one who suffers periodically or fre-
quently  with  this  malady should not  neglect  it, as
many do.
   Headache is an exceedingly common  affection in all
civilized countries.   It is more frequent among women
than among men, and from fifteen to  fifty than  either
before or after  these ages.   It takes a variety of forms,
depending principally upon the particular causes which
produce  it,  and upon  the  constitution of the patient.
Ordinarily it is  symptomatic  rather than idiopathic,
depending upon a morbid condition of some other organ
or organs than the head.  The term cephalalgia includes
every variety of headache.  The philosophy of the dis-
ease it is not always easy to determine.  Which of the
particular membranes  of  the  brain and  surrounding
tissues is the seat of the pain has been the  theme of
much speculation among medical men, and still there is
more or less  obscurity surrounding the matter.  The
philosophy of pain is the same, be it in one or another
part of the body.  Its seat  is always in the  nervous sys-
tem.  The  nerves of  sensation, when  in  health, take
cognizance of external things through touch, sight, smell,
hearing, etc. The point of a pin brought in contact
with the  tips of the fingers is recognized by the sense of
touch, and its character determined so far as  touch can
determine it.  Press the pin sufficiently hard into the 
HEADACHE.
113
flesh, and pain ensues.   Now why this pain?  It is the
action of the nerve of sense carried beyond the  degree
which permits the sensation to be agreeable.  Every
sense may become painful when the nerves of the organ
through which it is manifested become  intensely  active.
Light is agreeable to the eye, but too much  light  causes
such  intense excitement of  this organ as to make it a
pain instead of a  pleasure.  Pain in the head, or head-
ache, no doubt has its pathological condition in excessive
action of the nerve centers, or those  tissues and mem-
branes highly endowed with nerve ramifications.   It  may
be in the muscles of  the head, in the periosteum, or in
the brain substance.  It may have a multitude of  causes.
A blow on the head may occasion it.   A tumor may be
the exciting  cause.  Ardent  spirits may excite it.   In-
tense excitement of  the nervous system, exposure  to a
cold, damp  atmosphere, or to foul air in which is much
carbonic  acid gas, or to hot sunshine, often produces
headache.  By far the larger share of headache, however,
has its origin in that foul state of the system, particularly
the stomach and  bowels, caused either by bad dietetic
habits, or  by  an  insufficient  elimination  of morbid
matter through the bowels, skin, lungs, or kidneys.   A
stomach  overloaded with indigestible food, obstructions
in the bowels, inactive liver, lungs, skin, or  kidneys, all
have a tendency to produce a condition which results in
headache.  I have little doubt that it is often caused by
bad  air in persons whose  habits  are  otherwise  in the 
114                  HEADACHE.
main correct.   The tendency of the confined and impure
air in unventilated bedrooms,  crowded and  overheated
churches, school-houses,  and places of public resort to
produce  headache is  proverbial.   Anything  that  tends
to prevent the complete  aeration of the blood, as seden-
tary habits, want of  exercise,  or improper bodily posi-
tions, as bendi 0 over  school-desks, stooping, as in sewing,
may and often does result in this disease.  Corsets and
tight clothing about the waist prevent the complete oxy-
genation of the blood by thorough respiration, in  the
same way that confined air and want of exercise do, and
often result in  headache.  Excessive exercise  of any
function  may produce headache.  An extra exertion of
the muscular system, particularly if in close rooms, or
where the  feet are kept  cold and  damp, and the head
dry and  hot, or the violent exercise of any passion or
emotion not unfrequently produces this disorder.  Many
cases occur as  the effect  of  hot sunshine.   Hot cakes
with melted butter, baker's bread, rich gravies and con-
diments,  the indigestible and obstructing dressings used
on turkeys and  chickens on Thanksgiving and other sim-
ilar occasions, produce much of the headache, and  even
more dangerous diseases, which so often occur after hol-
idays.  I once  knew a person  who  almost always had
headache after eating old cheese, and another who rarely
failed to have an attack  after eating buckwheat cakes
covered with butter and molasses.
  Headache is not generally a dangerous disease, but it 
HEADACHE.
115
is a very annoying one.  To know you must be a martyr
periodically for a lifetime is not very pleasant, particu-
larly when it  is prone  to  appear at those times when
you  desire  to make  more  than   ordinary  exertions.
To  be unable to make any engagement without fear-
ing that it may either prevent your fulfilling it, or de-
stroy your  pleasure or  usefulness, is  certainly most
annoying.
  In its treatment much can be done by way of preven-
tion.   In a multitude of persons it can be almost  or en-
tirely prevented; in others, it can be more or less modi-
fied  in its  severity and shortened in its duration.  To
eradicate it from the system, its causes  must be  sought
out.  This is not always an easy matter, particularly when
the patient  is sure  his habits are perfectly correct.   It
is not easy for him to see the connection between certain
habits, in which he thinks he takes pleasure in indulging,
and  their  logical   consequence, headache.  A   horse
breaks into your cornfield and destroys the grain.  You
see the spoiled ears, the horse's tracks, the broken fence,
and  trace the effect  back to its cause, the unruly horse.
Perhaps you go still farther backhand find out that  the
field was  not well  guarded  by a good fence,  or  the
watchful care of the husbandman.   In almost all cases,
the farmer who finds his crops destroyed can trace back
the effect to a cause, or, if he cannot, he knows some cause
exists.   In headache, however, those who are not  physi-
ologists cannot trace the connection  between cause and 
116
HEADACHE.
effect; hence they are apt to attribute it to anything but
the true source.  The last thing they did produced it,
they think, and that was unavoidable.  The horse  may,
however, jump, into  the cornfield because  the  fence is
low, and the last thing the patient did  may have pro-
duced  headache—often does—because the  system was
in just the condition to allow it.  A person lives on fine
bread, hot rolls, pork, gravies, does not  bathe,  and has
headache.  These habits are all perfectly simple !  True,
but they most  surely induce  constipation and  obstruc-
tion of the channels of circulation, and these  produce
headache.
  The preventive means are thorough, most scrupulous
cleanliness, not alone of the  skin  and external  surface,
but of all the avenues, all the large  and  small channels
of circulation for the fluids of the body.   Cleanliness is
next to godliness, but it must not stop with the  external
surface; the  internal is of much  greater  consequence.
Cleanliness can be secured only through  the  means ap-
pointed by nature for that end.  These are the bowels,
the skin, the kidneys, and the lungs.  How these dif-
ferent channels  for depurating matter may be kept in the
highest state of healthy activity is a matter of  much
importance to those who would retain or improve  their
health.  The laws which regulate bodily cleanliness will
now be considered.
  In the domain of organic life there is constant  activity.
Activity begets a using up of the substance of the active 
HEADACHE.
117
organs, a breaking down of its  parts.  Take the brain,
for instance.  In using it vigorously  for an entire day, a
portion of  it is used up by being converted into debris,
or broken-down tissue.  In this state it is little different
from decayed flesh ;  but it is still in the body, and while
there produces  uncleanliness.  It  is this decayed, un-
clean matter  that causes fetid  breath and unpleasant
odors to arise from the skin and  from the evacuations.
In other words, the body becomes unclean by the decay
of its own substance—at least this is one of  the sources.
Another is the eating of too much food.  The law which
relates to the quantity of  food is, to take as much as the
system  requires and can properly digest, and this de-
pends upon the person, his habits, and various other cir-
cumstances.
  No doubt in health, and when the  appetite is  normal,
we can, to a great extent, be guided by it; but in too
many cases the  appetite is more likely to lead us astray
than to  guide us aright.   Superfluity of  food  is  not
only useless but injurious.  It cannot  be well digested
nor assimilated, but passes into  the circulation, partially
or wholly decays, and thus adds another  source of un-
cleanliness and  obstruction.   I am no advocate for low
and meager diet.  Every human being needs and must
have sufficient food to be well nourished ; but persons of
sedentary and inactive  habits are very apt to take more
than nature  requires,  and this excess often occasions
headache.  Still another cause  of  uncleanliness  of the 
118
HEADACHE.
body is the  indigestion of food  that is not of the best
quality.  It is not enough for the healthy support of the
body that the amount of food ingested should be suf-
ficient ; it  is equally important that  it be wholesome.
Dr. Carpenter says, in his " Physiology," that " It  is a
fact, familiar to German toxicologists, that cheese, bacon,
sausages, and many other  articles may  spontaneously
undergo such deleterious alterations as to give rise, when
employed as food, to all the symptoms of irritant poison-
ing,  and which may even eventually produce fatal conse-
quences."  I am strongly inclined to believe  that  the
large amount of pork and lard, gravy and fine bread, in
the shape of hot biscuit and cakes, has much to do with
producing a filthy condition of the stomach and aliment-
ary canal, and such  thickness of the blood as results in
headache, and often in more serious diseases.  Of all the
kinds of flesh used  for food  in America, pork is the
worst.   It possesses very little nutritive power, and that
of the lowest order.  Who will  estimate the number of
headaches caused by pork ?  People  who live in the
city  will often inquire: " Why is the  hog  unwhole-
some ?"  And the answer might be,  " If for  no  other
reason, because he is always kept so filthy."  The same
necessity exists for purity and high quality of food that
exists for good timber in  constructing a  ship that is to
withstand the storms of the ocean.  Food is the timber
from which our bodies are constructed, and their quality
depends, digestion and assimilation being equal, upon its 
HEADACHE.
119
quality.  It is a common belief that the hygienic sys-
tem of medicine advocates an innutritious, meager, in-
sipid  diet.   It advocates just the reverse—a nutritious,
abundant, and luxurious diet.  I have occasionally dined
at a boarding-house table where  the subject of diet has
been  discussed,  and while boarders  and others have
taken  occasion to pronounce anathemas against a hy-
gienic table as one that  produced  starvation, they have
done  most of the starving themselves.  Many  a man
becomes starved on the diet of  boarding-houses  and
hotels, for want  of sufficient nutrition, and variety and
purity of food.   I have  been led  to  these remarks on
food because cleanliness of the body depends so much
upon it, and headache is so often the result of uncleanli-
ness.
   Nature's method of removing the  broken-down  and
decaying portions of  the body is accomplished through
the bowels, the skin, the kidneys, and the lungs.  Even
with the best of food, if these organs become obstructed,
uncleanliness will inevitably be the result.  The bowels
are kept free  by coarse  bread,  ripe  fruits, hominy,
cracked wheat, an absence of concentrated substances,
and abundant exercise.   Where the patient is unable to
take sufficient exercise, an attendant should percuss and
otherwise manipulate the abdomen in  a great variety of
ways, as performed in the movement  cure.  Very often
all that is needed to prevent headache is to remove con-
stipation, obstruction, and torpidity of  the liver, stomach. 
120
HEADACHE.
and bowels;  and the operations of the  movement cure,
with wholesome food, are almost always sufficient.      >
   The skin is kept active for its duties  by  clothing,
friction, exercise, and thorough bathing. If  the patient
has few of the conveniences for the bath, thorough fric-
tion with a damp towel  and the hand  is often the very
best.
   The lungs are made to do their  duty by giving them
all the pure  air  they need at  all  times and under all
circumstances.   If  they  are contracted  so  as to do less
than they should, they must  be trained or educated in
the gymnasium, and by means of the  movement cure,
or medical gymnastics, so as to increase their size.
   The kidneys  need only pure water  as  a  beverage,
along with the fluids found in ripe fruits, to be sufficiently
active, in addition  to  exercise, which,  when judicious,
provokes all the excretory organs to their duty.
   To treat a case of sick headache, in  addition  to the
preventive measures mentioned, we may use, during the
attack, the following means: The patient should occupy a
cool, dry, and well-ventilated room; place the feet in hot
water for a few minutes, to increase the circulation in them
and withdraw the blood from  the  head; drink rather
freely of warm water, so as to either produce vomiting or
dilute the offending matters in the stomach,  and make
their removal more easy.  If there be  fever, a sponge
bath will afford much relief.  Cloths wet in the coldest
water should be applied to the head,  and  frequently 
HEADACHE.                  121
changed.  Sometimes  a showering of the head in cold
water will give instantaneous  relief.  Warm or cold fo-
mentations, as are most agreeable, over the stomach and
abdomen  are very valuable.  A  copious injection of
tepid water into the bowels will prove highly serviceable.
Little or no food should be taken until the appetite re-
turns.   Pills and powders are of no  use, but  rather do
harm.  Observe quiet as far as possible, and, in a major-
ity of cases, relief will  be afforded, often in a few mo-
ments, almost always in a few hours. 
NOTES  CONCEKNING  HEADACHE.
  Headache is sometimes  caused  by long-continued
straining of the eyes, especially where there is irregular
refraction, and the images of the two eyes are not brought
to a focus, but two images are produced.  When this
cause is  suspected, the eye should be examined  by an
oculist, and the defect corrected.

  Headache in children should always attract our atten-
tion, and the cause, if possible, be discovered.  In case the
child is attending  school, probably this and the confine-
ment in bad air are the causes.  The brain of a child is
tender, and, when  used over  books,  flushes with blood
and  rises in temperature.  When this  increases to an
abnormal extent, pain is  the result.   This is the head-
ache of congestion.   The cure is apparent.

  Sudden excitement may produce headache, by a too
rapid dilatation of  the vessels of the brain.  This is apt
to occur in those  persons who have too little blood in
their systems, or it may occur when there is an excess
of blood.  If from the latter cause, the patient must eat 
NOTES.
123
less  and exercise more.   If  from the former cause, he
must eat and digest more, and lead a more quiet life.

  Headache from bad air is very frequent in those who
go much to parties, theaters, illy-ventilated churches, and
crowded assemblages.  The  carbonic acid of the blood
accumulates to such an extent as to cause blood poison-
ing.   There is no cure  except  pure air.  And, indeed,
pure  air is one of the most  efficient cures for all forms
of headache.  But the air must  be taken into the lungs,
and  not merely  come in contact with  the skin.  We
have  noticed generally that  those who suffer much  with
headache are small  breathers.  They live in the air, but
do not  take it into  the  lungs in sufficient quantities to
answer the ends of perfect nutrition—for the air is only a
gaseous food.   Such persons should educate their lungs
to take  full  respirations.  Several times a day should
they inflate  these organs to their fullest extent.   The
muscles  of the chest should be trained  to act without
constantly giving thought to  the matter.  If people  only
knew how much good full drafts of air would  do them,
they would be more anxious to  obtain them than  they
are now.  Fill your lungs with pure air rather than your
stomachs with medicine, oh !  ye who are victims to head-
ache.

  As a proof that want of  fresh air is a cause of head-
ache, and a supply of it a cure, it may be mentioned 
124:
NOTES.
that the inhalation of pure oxygen, or an  atmosphere
rich in oxygen, has been known to cure the most distress-
ing periodical headaches.  Pure, fresh air ought to be
equally or nearly equally as good.

  Sometimes the hot sun will cause a headache.   When
this is the case with any person, he should avoid being
exposed to the rays of this orb in the heat of a midsum-
mer day.  And as a remedy for a headache  brought on
by the rays of the  sun, a deep, hot foot-bath and  cool
applications to the front head are very beneficial.

  Bathing  in the sea, when the surf is high, may cause
headache, if the bath be a long one,  and the person
enters into the excitement too  earnestly.   On  the other
hand, wading barefooted along the beach, with an  um-
brella  over the head, for half  an hour, in pleasant  wea-
ther, is a good preventive of headache.  On a pleasant
day the air along the ocean shore is rich in ozone, which
ought to relieve headache, if breathed in abundance.

  Riding  on horseback with pleasant company, or  on a
horse that you are fond of, and that does not jolt you by
hard trotting, is a capital remedy for headache in  young
girls.   It promotes  digestion and respiration, and  this is
of the greatest importance.   It cannot be practiced  in
all weathers, but it can be used in pleasant weather, and
in  the  early morning, when  the air  is  pure, to great
advantage. 
NOTES.
125
  Working out of doors may, in the case of women, both
cause and  cure  headache.  An occasional hard day's
work in the hot sun by a person not used to it causes
headache; but we have known several cases cured by
doing light work out of doors, in  a  short dress, months
in succession.  The remedy is worth trying.

   Going without a meal may  bring  on  headache, but it
could hardly do this in a perfectly healthy person.  Men
and women ought to be tough enough to miss a meal
now and then without suffering so much from it.  Eating
a hearty late dinner may cause headache next day.   The
remedies in such cases lie in the hands of the victims.

   Too much or too little food will cause headache.   The
remedy is apparent.

   Alcoholic  drinks  are  a  fruitful source  of headache.
Avoid them.

   A hard headache may sometimes be relieved or cured
by baring  the arms to  the elbows, and thrusting them
into hot water,  holding them there till they are  red.
The feet may at  the same time be plunged into hot water
up to the knees.

   The same effect may be produced by baring the arm
to  the  elbow, and letting  some healthy person slap it 
126
NOTES.
 with both hands gently, but hard enough  to  produce a
 stinging sensation.  In slapping, both hands  should be
 brought together, and come in contact on opposite  sides
 of the  arm at the same moment.  If done skillfully, it
 will often relieve a nervous headache.  If done roughly,
 it will make it worse.

  A headache may be the result of rheumatism.   Cure
 the  latter disease, and the former will pass away.   Such
 headaches  are very  common  and  distressing.   They
 are best avoided by strengthening the constitution,  espe-
 cially the liver, and guarding  against excesses in eating
 or working.   For this kind of headache cold water is not
 generally best, except as  applied from the ends of the
 fingers, when held for a few moments on the roots of the
 trifacial nerve, just in front of the ear.

  The long hair done up so as to make a covering for
 the head, increasing the heat of the scalp, and retaining
 the dandruff, may cause headache.  The fashion of  long
 hair and heavy  false  hair for women is  so rooted  into
 the  ways of the world that it may  never  be changed,
but so far  as health is  concerned it is  a  bad fashion.
The  hair need not be cut off  like a man's, but it  may
be much shortened, and so arranged as to require little
care, and do no harm to the head.  Who will help intro-
duce such a fashion %

  Wetting  the forehead is often beneficial,  especially if 
NOTES.
127
the head be thoroughly rubbed and shampooed after-
ward  and then dried.  It is a pity that shampooing the
head  cannot  come  into more general practice.  If it
could be done every day it would prove almost a panacea
for many forms of headache.  The lower back of the
head  should not be wet with cold water, but may be wet
with  hot water.  Indeed, pouring  hot water over the
cerebellum will sometimes cure headache.

   Stovepipe  hats  are  often  an exciting cause of head-
ache.   True, they are  dressy and elegant  and must be
worn  on certain occasions, but they  should always be
ventilated thoroughly by holes in the top.   They should
also be made as light and easy fitting as possible.

   Tight boots and  shoes will cause  headache.   They
should never be worn.  They destroy comfort, grace of
motion, and happiness.  They prevent the flow of blood
in the extremities, and cause slight congestion  of  the
brain.  The shoe should be made to fit the foot, and not
the foot to fit the shoe.

  As  a preventive  of headache the daily bath must not
be overlooked.   It fortifies the system as no tonic does.
One of the best forms of morning bath is to dash water
over the entire person  suddenly, then rub the skin hard
for a  moment with the hands, and then throw a sheet
over the body and rub over this till  dry.  It should be 
128
NOTES.
thoroughly done and cause a glow, not slowly nor feebly
done, causing a chill.

   Having the hair combed by a person with a magnetic
hand for half an hour will often reheve headache.   An
interesting case of this sort came under our notice lately.
A gentleman who suffers most excruciatingly with peri-
odical  headache, caused by dyspepsia  and exhaustion,
sat down, and his little niece, a beautiful girl, combed his
hair a little while, when all the pain left him.  But it is
not every one who has a beautiful little niece to do such
work.

   Exhaustion from overwork, thin blood, or too little
blood are frequent causes of headache.   In all such cases
the true  remedy lies in building up the system  by true
hygienic remedies, such as wholesome food, rest, recrea-
tion, and in  taking care not to  overdo.  Such persons
ought not to  be burdened with too much care. Let such
eat all the good food they can digest.  Corroding care
is the  bane of life to many.  Too  little care, to many
more.

  It is  sometimes  the  case that a person  will suffer
for years  with a  most distressing headache and  not
know the  cause.  The  doctors  can do the patient  no
good, and often do him  much harm.  In such cases it is
well to suspect gall-stones, and if they are proved, a good 
NOTES.
.129
method of procedure is to take, on going to bed at night,
two ounces of sweet oil.  After going to bed, manipulate
over the liver  with  the hands, or have it  done pretty
thoroughly, so as to excite to action  all the deep tissues,
and in  the  morning take once in thirty minutes  a  seid-
litz powder, till the bowels operate.  Repeat this once in
five days, till the gall-stones are all out.  The success of
the operation depends on the thoroughness of manipula-
tion.   This alone will often drive them out.  It is not
absolutely necessary  to  take  the  powders.  The oil
softens  and lubricates the parts so  that  there  will be
little pain.  Should the pain be intense, hot fomentations
over the  liver will  alleviate  it.  If no gall-stones are
found, little harm can come from this treatment.

   Heavy six o'clock dinners  often  cause  persons to
awake  next day with  headache.   In such cases, the
remedy is apparent.   It consists in  eating less.  Those
who are not willing to make the sacrifice must continue
to suffer.   They  certainly cannot expect health without
paying the price, which is  obedience to nature's laws of
health.

   Tea-drinking is often an unsuspected cause of head-
ache, causing as  it does exhaustion of the  nervous sys-
tem.  Those who will use it should do so in moderation.
Take it weak and after the meals, rather than between
or before them. 
ISO-
NOTES.
  We translate from Niemyer's "Atmiatrie" the follow-
ing paragraph:  He says:  " It  was recently my lot to
listen to a conversation in a country tavern,  between
country people, concerning  some wooden barracks which
had  been  erected for  soldiers.  The landlady  said:
1 Since we came to dwell in this board booth we all sleep
better, and I have lost that  troublesome headache which
formerly annoyed me so much.'  ' Ah !' said a guest,' that
is  because formerly you slept in  a  foul, closed room,
while here the fresh air penetrates through the many
cracks.'"   The author asks: " How  would the people
like  it if  for headache, instead of drugs, the physician
should prescribe a  change from sleeping in closed rooms
to open barracks ?"

  The current  proverb,  "that  long sleep causes  head-
ache," is best explained by the fact that, if the room is not
ventilated, the air becomes  so poisonous, by many hours'
breathing over and over, as to cause  it.   A long sleep
in a well-ventilated room  will  not cause the  head to
ache.

  Some severe  forms of headache may have their origin
in defective circulation  caused by disease of the heart.
When this is the case there is much to be hoped for by
taking good care of the  general health, avoiding all ex-
cesses and excitements, and living strictly according to
the requirements of nature, whose laws are beneficent. 
NOTES.
•  131
  Coffee often causes headache, but few will admit this.
It is a drink which  people are very apt to abuse if they
use it at all.  It should never be taken strong or in large
quantities, and those who find  it injurious should dis-
card its use altogether.

  Going  without sleep, or  taking too little  sleep, is a
cause of headache which can only be remedied by op-
posite means.   Most  people require  eight hours out of
twenty-four for  sleep, in order  to perfectly restore the
nervous system; a less  amount leaves the nerves and
brain weak, and a ready prey to evil influences.

  The  headaches  of old age are  generally caused by
taking  too much food—more  than  is required by the
work done and more than can be digested.   The remedy
is moderation  at the table.-  Most  of the dangers to
health in advanced  life may be guarded against by mod-
erating appetites and desires to the strength.  As the
powers of life wane, they should not be taxed more than
is wise.

  Very severe and distressing  headaches arise from a
failure of the kidneys to  act.  When this is the case, the
remedy must be applied to these organs.   A sitz bath,
hot compresses over the small of the back, gentle friction,
and an occasional glass of lemonade are good remedies.
The kidneys carry out of the blood urea, really a very 
132                    NOTES.
 dangerous substance, which if allowed to remain poisons
 the  blood.  It is  not certain that its very slight  accu-
 mulation may not be the  cause of more headache than
 is now known.  The skin secretes urea in small quan-
 tities, and if the skin is very active it may do the  work
 of the kidneys ;  but if it, too, is torpid and lazy, then look
 out  for headaches.   It  will be  observed that persons
 who suffer much with headache generally have a torpid
 skin.  They should  improve it by daily bathing.  The
 Turkish bath in such cases is excellent.

  One word concerning pleasure  and pain, and we are
 done.  These  two states stand to each other as opposites,
 as do heat and cold, wet and dry, strong  and weak, up
 and  down,  credit  and debit, plus and minus;  whatever
 mode of nervous excitement is present in pleasure  must
 be absent in pain.   We generally  connect  pleasure with
 high vitality,  pain with  low vitality, feebleness, and ex-
 haustion.  It  is true that  there are  exceptions to this
 rule, as there are to all, but still the fact holds good that
 a state of  pleasure is connected with  an  increase, and a
 state of pain with a  decrease, of all the vital  functions.
 Headache is no exception to this rule.

  In  closing  this  chapter we  must  apologize for  its
 somewhat  fragmentary character.  It was not written
for  the  physician, but for the people,  and  they  will
not fail  to pick  out of it such crumbs of knowledge 
NOTES.                    133
as may be of use to them.  We believe that more than
half the headache in the world is caused by little diso-
bediences to physiological laws, and a brief paragraph
may help to show  a sufferer where his or her trouble
lies better than an elaborate essay.  We would certainly
encourage all to hope that they  may, by obedience to
nature's laws, avoid headache, if they will only try hard
enough; but they must try wisely, and not ignorantly.

   In conclusion let us say that this little book has been
a labor of love, and we send it on its mission, hoping it
will prove, at least in some small  degree, serviceable to
• those for whom it is intended. 
 
INDEX.
Air, fresh, 73.
Angina Pectoris, 62.
Appetite, morbid, from deranged liver, 44.
Apples, how to eat, 80.
Artery, the hepatic, 12.
Bathing, 75.
Bath, the Turkish, 75.
Beverages, alcoholic, 69.
Bile, flow of, 16.
     from what secreted, 16.
     color of, 16.
     ducts, the, 14.
     ingredients of, 16.
     its necessity to life, 17.
     quantity of, 16, 21.
     the, 15.
     use of, 17, 21.
Biliousness, 84.
Body, cramped position of, 65.
Bread, unleavened Graham, 69.
Bright's disease from lithemia, 40.
Calomel, its action on the liver, 77.
Carriage riding, 74.
Cerebral symptoms, 59.
Cheerfulness, 75.
Climate and liver disease, 65.
        warm, bad for the liver, 86.
Clothing, tight, 65.
Cold hands and feet from deranged liver, 44.
Constipation from deranged liver, 45.
Convulsions, 54. 
136
INDEX.
 Cramps in the legs, 49.
 Depression of spirits, 57.
 Diarrhea from diseased liver, 45.
 Diseases, other, from deranged liver, 43.
         other, from uraemia, 42.
 Disease that breaks down the health, 66.
 Douche bath, 75.
 Drinks, 72.
 Ears, the, noises in, 55.
 Eggs, 70.
 Electricity for the liver, 90.
 Excitement, nervous, 66.
 Exercise, indoor, 74.
          outdoor, 73.
          want  of, 65.
 Fat, 28.
     people, troubles of, 28.
 Flatulence from diseased liver, 40.
 Food, 66.
 Foods allowed, 69.
       to be avoided, 38,69.
 Fruit, 70.
 Galen, views of, 19.
 Gall-bladder, the, 15.
 Gall-stones, 83.
            from uric acid, 40.
 Gastric juice, amount of, 23.
 Gland, description of a, 7.
 Gout from uric acid, 39.
 Grapes, 70.
 Gravel from  uric acid, 40.
 Greens, dandelion, 84.
 Gymnastics,  light, Dr. Lewis's, 74.
 Harvey, views of, 19.
 Headache, 50.
           nervous, 90.
           sick, 90.
 Heart, the, as affected by disease of the liver, 61,
Hemorrhoids from disease of the liver, 45,
Horseback riding, 73.
Hydatids, 84. 
INDEX.
Intemperance, 66.
Jaundice, 83.
          cure of, 83.
          from diseased liver, 46.
Lacteals, the, 12.
Lassitude, 47.
Leanness, 28.
Lifting cure for liver complaint, 92.
Liver, cancer of, 41.
       color of the, 9.
       complaints, causes of, 64.
                  cure of, 69.
       condition of, in phthisis, 30.
       contracted, 82.
       derangements of the, 26.
       displacement of the, 91.
       fatty degeneration of the, 41.
       fissures of the,  10.
       functions of the, 13.
       general view of the, 7.
       how held in place, 9.
       lobules of the, 13.
       location of the, 9.
       pain in the, 91.
       shape of the, 9.
       size of the, 9.
       sugar, 18.
             use of the, 19.
       torpid, 31.
             symptoms of, 32.
       vessels of the, 10.
       weight of the, 9.
Lungs, inflammation of the, from uraemia, 4%
Manipulations, 75.
Mastication, thorough, 79.
Meat, 70.
Megrim, 50.
Melancholia, 61.
Miasma, 64.
Milk and the liver, 81.
Mouth, the,  as affected by deranged liver, 43. 
138                        INDEX.
Nerves, the, as affected by liver disease, 47.
Neuralgia from hepatic colic, 48.
           hepatic, 47.
Nutrition, abnormal, 28.
Oranges, 70.
Pains, aching, in the limbs, 47.
Pancreatic juice, amount of, 23.
Paralysis, 55.
Pate de foie gras, 82.
Peculiarities,  constitutional, 66.
Poisons, 66.
Questions, miscellaneous, answered, 77.
Relation of the liver to the kidneys, 35.
Rheumatism,  acute, from uraemia, 42.
Rowing, 73.
Shoulder, pain in the, 47.
Sideache, 85.
          from diseased liver, 46.
Sitz bath, 75.
Sleep, 75.
Sleeplessness,  56.
Spices, 72.
Spirit drinking, 38, 82.
Stomach, irritation of, 89.
          sinking at the pit of, 85.
Strawberries,  71.
Sympathy between different organs, 41.
Tea and coffee, 69.
Temper, irritability of, 58.
Throbbing sensation in the arteries, 62.
Tipplers, troubles of, 28.
Tomatoes, 71.
Treatment,  magnetic, for dyspepsia, 87.
                     in costiveness, 88.
                     rules for, 86.
Typhoid state, the, 59.
Urates, the, 36.
Urea, 35.
Uric acid, 36.
           caused by liquor drinking, 38.
          diseases caused by, 39. 
INDEX.
139
Uric acid, in the blood, symptoms of, 36.
Vein, the portal, 11.
Ventilation, want of, 65.
Vertigo and temporary dimness of sight, 52.
Water drinking, 38, 92.
       poisons taken in, 64.
Waters, mineral, 76.
             Index to Dyspepsia.
Butter in its relation to dyspepsia, 103.
Diet, low effects of,  101.
Discontent and fidgeting, 104.
Dyspepsia, a disease of the brain, 97.
           confined  to the studious,  102.
           cured by resting the brain, 101.
           found among the temperate and careful, 103.
           from blows on the head, 97.
           from mental affections, 97.
           not caused by gluttony, 105.
           several ways of curing, 107.
Esquimaux, diet of the, 105.
Gluttony as a cause  of dyspepsia, 103.
Good living in its relation to dyspepsia, 102.
Hard study not injurious, 106.
Headache from intoxication, to prevent, 99.
Insanity from dyspepsia, 97.
Liquors, their relation to dyspepsia,  102.
Nutriment, insufficient, 105.
Passions, excitement of, injurious, 106.
Siberians, diet of the, 105.
         Index to Essay on Headache.
Air, pure, 123.
Assemblages, crowded, 123.
Bacon, poisoning from, 118.
Bath, the hot, to the extremities, 125.
Breath, bad, cause of, 117.
Cheese, poisoning from, 118.
Cleanliness, 116.
Diet, hygienic, not a starvation diet, 119.
Dinners, late and hearty, 125.
Drinks, alcoholic, 125. 
140
INDEX.
Fomentations, 121.
Food, too little, 125.
          much, 117, 125.
Foot-bath as a remedy, 124.
Gall-stones, sweet oil as a remedy for, 129.
Headache, benefit in, from shampooing, 127.
                        wetting the forehead, 126.
          caused by sea bathing, 124.
          cause of, unknown to the sufferer, 128.
          cold water not good for certain kinds of, 126.
          cured by certain hygienic remedies, 128.
                   having the  hair combed  by a mag-
                      netic hand, 128,
                   hot water to the cerebellum, 127.
          daily bath as a preventive of, 127.
          from blows,  113.
               buckwheat cakes, 114.
               cheese, 114.
               coffee drinking, 131.
               damp, 113.
               defective circulation, 130.
               deficiency of blood, 128.
               excitement, 113, 122.
               foul air, 113, 114.
                   stomach, 113.
               inactive bowels, 113.
                      kidneys, 113, 131.
                      lungs, 113.
                      skin, 113.
               late and heavy dinners, 129.
               ardent spirits, 113.
               long hair, 126.
               long sleep explained, 130.
               overwork, 128.
               rheumatism, 126.
               sleeping in close rooms, 130.
               straining the eyes, 122.
               tea drinking, 129.
               thin blood, 128.
               tight boots and shoes, 127.
                    clothing, 114. 
INDEX.
141
Headache from too much or too little care, 128.
               want of sleep, 131.
               wearing corsets, 114.
                        false hair, 126.
                        stovepipe hats, 127.
          gall-stones as  a suspected cause of, 128.
          horseback riding for the, 124.
          hot sun as a cause of, 124.
          from congestion, 122.
          of old age, cause of the, 131.
          prevention of, 115.
          pure oxygen for, 124.
          remedies for the, 131.
          torpid skin as related to the, 132.
          Turkish bath for the, 132.
          working out-door as a cause and cure of, 125.
 Kidneys the, how made to do their duty, 120.
 Lungs the,    "    "    "  "    "   "   120.
 Nature's method, 1:9.
 Odors, unpleasant, cause of, 117.
 Omitting a meal, 125.
 Pills and powders, 121.
 Pleasure and pain, their relations, 132.
 Pork, 118.
 Rooms, ill-ventilated, 123.
 Sausage, poisoning from, 118.
 Showering the head, 121.
 Sick-headache, additional measures, 120.
 Skin, how to keep active, 120.
 Spatting the arm, 125. 
 
 
 
 
 
 

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