fecting the liver, become
constipated, thus causing much additional work on the part of the
liver in handling the products produced as the result of putrefactive
bacteria upon the accumulated mass in the colon.

~Tissue Changes~ in the liver have been caused by the taking of
alcohol, which should therefore be avoided by all individuals having
any disease involving the liver and by those with a predisposition to
liver disturbances.

~Exercise and Lack of Exercise~ are potent factors in the treatment
of conditions involving the liver. First, because the liver requires
exercise to enable it to empty itself more completely and assure a
free flow of bile; second, because exercise directly affects the
energy output of the body, causing an increased rate of metabolism and
a better utilization of the food ingested. Lack of exercise acts in
exactly the opposite direction, and it has been found that with the
majority of patients suffering from diseases of the liver too little
exercise and too much food are at the bottom of the trouble.

~Dietetic Treatment~ in the majority of diseases affecting the liver
is much the same. The keynote in each is a balanced diet. Constant
overeating and excessive drinking have proved the foundation of the
majority of such diseases, especially of the bilious type, while an
excess of fat and carbohydrates in the diet lead to the more serious
disorders.

~Biliousness~ requires abstinence from food for a short period and a
cleansing of the entire gastro-intestinal tract, the measures being
directed by the physician. After the bilious symptoms have subsided, a
simple, well-regulated diet should be established, in which no rich
foods of any sort are allowed. All condiments and spices which have an
astringent effect upon the bowels are strictly prohibited, and
alcoholic beverages had best be eliminated from the diet.

~Cirrhosis~ of the liver is apt to be insidious in its development,
taking a firm hold before the character of the disorder is discovered.
Dietetic treatment of this disturbance is most important and should be
directed toward overcoming not only the liver symptoms but other
symptoms as well.

~Gastro-intestinal Disturbances~, manifested in cirrhosis of the
liver, are treated by the diet used in chronic gastritis (see p. 250).

~Heart Symptoms~ sometimes occur during the course of the disease and
require especial attention to the diet. The fluids at times must be
restricted, in which