Page:The Principles and Practice of Medicine.djvu/279

Rh bowels be freely acted upon by an active aperient. If there is reason to believe that obstruction exists, the cause of the ob- struction must, if possible, be removed ; but frequently this can- not be accomplished, and then treatment will be of little service- When no cause for the jaundice can be discovered, mercury may be cautiously given with taraxacum and aperients. Nitric or nitro-muriatic acid may be taken, and the side sponged with the nitro-muriatic acid lotion. Saline diuretics are often useful.

Gall stones.—Small calculi are apt to form in the gall bladder or biliary ducts ; they consist of cholesterine and inspissated bile. In passing along the ducts, they cause violent paroxysmal attacks of pain, which must be relieved by opiates, and the inhalation of chloroform. Once in the duodenum they escape with the faeces.

Diseases of the pancreas.—Of the diseases of the pancreas but little is known. The organ has been found enlarged, and its structure changed, sometimes from inflammation, but more frequently from cancerous formations or fatty degeneration. Cal- culous concretions in the pancreatic duct are common. The symptoms which have been noticed, when the pancreas is diseas- ed, have reference to derangement of the stomach, which is probably produced by the pressure of the enlarged organ. Fatty stools have also in some cases been passed.

Diseases of the spleen.—The spleen no doubt is liable to inflammation and its results, but such disease is rare and of little pathological importance. Enlargement of the spleen, in connection with malarious fevers, will be afterwards considered.

Situation of the kidney.—The kidneys, imbedded in much fat, are situated at the back part of the abdomen, on a level with the last dorsal and two upper lumbar vertebrae. They are too deeply-seated to be affected by pressure from in front ; but if the