A practical treatise on the diseases of the liver and biliary passages / by William Thomson ... also, Clinical illustrations of diseases of the liver and spleen, by William Twining.

  • Thomson, William, 1943-2017.
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of the liver and biliary passages / by William Thomson ... also, Clinical illustrations of diseases of the liver and spleen, by William Twining. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    digestion depends; which condition being disturbed, digestion must be deranged; and the reality of the disturbance of which may unequivocally be inferred from the derangement of digestion. We need seek for no more striking proof of the very general preva- lence of this pathological theory of indigestion, viz., that the essence of the disorder resides in the liver, as has been said by one of its supporters, than the almost universal adoption, in the treatment of that class of maladies, of a remedy, the beneficial action of which is supposed to depend mainly on its being capable of bringing the liver to a healthy state of secretion. But when we consider how very complicated a phenomenon digestion is, it becomes apparent that there must be many other causes of its de- rangement besides disturbance of the biliary secretion; and that, consequently, some more positive proof is necessary of such dis- turbance, than the mere occurrence of indigestion. It must be acknowledged, said the late Mr. Twining, in his Clinical Illustra- tions of the more important diseases of Bengal (I. 207), that the presence of functional disorders of the liver is often assumed to exist, on very vague and trivial grounds; and modes of treatment are adopted, in consequence of some imagined affection of the liver, which are not only unnecessary, but, it is to be feared, sometimes absolutely injurious. The uncertainty of the results of treatment pursued on such grounds, is much to be lamented. I trust we shall not meet many practitioners in the present day who are satisfied, without any distinct evidence on the subject, to ascribe every ob- scure chronic disease to some functional disorder of the liver, and who suppose they are acting on reasonable principles, while they injure the patient's constitution by persistence in the use of mer- cury. DIMINISHED BILIARY SECRETION. 9. That the secreting operation of the liver, like that of other glandular organs, as the kidney, the testicle, &c., may, under certain circumstances, independently of structural alteration, go on with less than its usual activity, and that the bile may consequently be deficient in quantity, is on many accounts very probable, though it may reasonably be doubted whether this be so frequent an oc- currence as is usually supposed. We are far from possessing the same facility in judging of the manner in which the liver exercises its secretory function, that we possess in respect of the kidney/. The only positive means, indeed, by which we can ascertain, during life, the occurrence of a deficient secretion of bile, — im- plying, where no structural disease is present, the existence of what is called by some pathologists torpor of the liver, — is our finding that the alvine evacuations are, in a greater or less degree, destitute of the colour which they receive from this fluid — are more or less pale, or of a dull white or ash colour, without this state of the stools being accompanied with the occurrence of any