in the right lobe, whereas other
forms due to septic infection give rise to many abscesses.

Causes.--This disease is rare even in tropical climates. When it is
excited by gall stones, it is invariably septic in character and the
infecting material reaches the interior through the liver vessels or bile
passages. Stomach ulcers, typhoid fever, appendicitis, may bring on such
an abscess. Pus wounds of the head are sometimes followed by a liver
abscess. The most common method of infection is through the portal vein.
Other causes that may be mentioned are foreign bodies traveling up the
ducts, as round-worms and parasites.

Symptoms.--Hectic temperature, pain, tenderness, and an enlarged liver,
and often slight jaundice. In acute cases the fever rises rapidly,
reaching 103 or 104 in twenty-four hours. It is irregular and
intermittent, and it may be hectic, that is, like the fever of
consumption. Shakings or decided chills frequently are present with the
rise of fever and when the fever declines there may be profuse sweating.
The skin is pale and shows a slight jaundice, the conjunctiva being
yellowish. Progressive loss of strength with disturbance of the stomach
and bowels is present. The bowels are variable and constipated and loose.
Dropsy of the abdomen (Ascites) may develop, on account of pressure on the
big vein, inferior vena-cava. Lung symptoms, severe cough, reddish-brown
expectoration are often present.

THE ABSCESS.--May break into the pleural cavity, bronchial tubes, lungs
and stomach, bowels, peritoneum or through the abdominal wall.

Recovery.--The result is unfavorable as it generally goes on to a rapid
termination. The abscess should be opened and evacuated when its location
can be detected. The death rates ranges from fifty to sixty per cent.

Treatment.--Open it if you can, Sponge liver region with cool water. For
the pain, mustard poultices, turpentine stupe or hot fomentations prove
beneficial. Keep up strength by stimulation and quinine.

[DIGESTIVE ORGANS 133]

Diet in Liver Troubles sent us from Providence Hospital (Catholic),
Sandusky, Ohio:

May Take--

Soups--Vegetable soups with a little bread or cracker, light broths.

Fish--Boiled fresh cod, bass, sole or whiting, raw oysters.

Meats--Tender lean mutton, lamb, chicken, game, (all sparingly).

Farinaceous--Oatmeal, hominy, tapioca, sago, arrowroot (well cooked),
whole wheat bread, graham bread, dry toast, crackers.

Vegetables--