Passive Congestion of the Liver
RESULTS from mechanical obstruction to the outflow of blood from the liver. When this condition has existed some time, there is a sense of weight and fullness in the liver region when sitting up or lying on the left side. The liver is enlarged and tender; the breath is shortened, and pain may be present, extending to the shoulder.
Jaundice is usually present, but only t,) a slight degree. When the heart is the cause of the obstruction to the outflow of blood, there is often present an associated gastro duodenal catarrh, in which case loss of appetite, nausea, vomiting, belching of gas, and pain, are also present. In the later stages of a prolonged case, ascites, or dropsy of the peritoneal cavity, is present.
Prognosis. The outcome of passive congestion of the liver is usually grave, since it is the result of some structural disease else where, as of the heart, asthma, chronic pleurisy, tumors, etc.
Treatment. The indications for treatment are to strengthen the heart with digitalis, strophanthus, etc., increase the strength of the patient with strong, stimulating food, and to deplete the portal circulation by vegetable laxatives like podophyllin, rhubarb, aloes, etc.; the salines also furnish an agreeable method of depletion, as for instance, Crab orchard water, Hunjadi, etc. It occurs usually after middle life, and is more common in women than men. It is usually secondary to other diseases, as in the bowels or stomach, rectum and womb. The liver is increased in size, and is frequently studded with smallish nodules, which in well marked cases may be felt through the abdominal wall.
The disease usually gives rise to loss of appetite, nausea, vomiting, constipation, emaciation and weakness. Pain over the liver is generally present, while jaundice exists in about fifty per cent of cases. Dropsy of the bowels exists likewise in about the same proportion of cases. Hemorrhages from the nose, stomach and bowels occur in the later stages of the disease. The temperature is usually lower than normal, and the pulse slow, especially if jaundice be present; the urine is diminished in amount and high colored. The disease progressively advances to a fatal termination inside of a year. No known treatment is of avail in arresting the terrible malady.
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