We have often observed that people suffering from diseases of the liver feel and look much better after abstaining from meat and living on milk and a vegetarian diet. If such a diet be beneficial in cases where the tissues of the liver are degenerated, it appears reasonable to assume that it will be equally efficacious when the liver has not yet been altered by disease. We must realize that the various unwholesome matters we eat or drink are carried to the liver to be dealt with, and that the end-products of the decomposition of the meat, and other elements contained in preserved meat which may not be perfectly sound, may injure the liver-tissue, or, at any rate, throw more work on this organ than food in the nature of vegetables or milk.
A milk diet has the further great advantages that it assists in destroying toxic products in the intestine, and also that it can hinder the development of gall-stone disease (see Chapter XXXIX).
Not only meat used in abundance, but also various kinds of spices, condiments and stimulants may be very injurious, especially alcohol, if taken in large quantity. Gin and brandy are the most deleterious in their action. Wines containing little alcohol are less harmful, but acid or strong white wines may injure the liver-tissue.
The well-being of this organ is essentially dependent on the good condition of various other organs with which it stands in very close relation, in particular the intestines, for instance. It is from here that most of the toxic products enter the liver, either by the portal vein or through the choledochus. The intestine always contains myriads of microbes, which may enter the liver either by the blood or the bile, and thus provoke very important changes in the liver-tissue. Professor Adami,[186] of Montreal, found colon bacilli in a cirrhotic liver.
It follows, therefore, that we must maintain the intestine in the best possible condition, and avoid constipation and stagnation of fæcal matters, with the augmentation of toxic products. That constipation is very deleterious to the liver can be best shown by the fact that very often affections of the liver and bile-ducts,—and especially gall-stone disease,—are developed in persons suffering from habitual constipation. The best treatment for these liver affections is a purging treatment, and it is mainly on account of their action in this manner that certain alkaline mineral waters have attained so great a fame; in addition, due to increased peristalsis, the circulation of the bile is enhanced.
Proper movements of the bowel are indispensable to a sound condition of the liver and for the prevention of hepatic disease, and we, therefore, refer the reader to the chapter that deals in detail with the prevention and treatment of constipation.
Not only the intestine, but the stomach also, must be in good condition. It has been noted by Bouchard and Hanot that chronic gastric and intestinal troubles are apt to cause enlargement of the liver. Bouchard has found an enlarged liver in 23 per cent. of his cases of dilatation of the stomach. Hanot and Boit[187] have shown experimentally that the different acids formed in the gastro-intestinal tract are able to produce a genuine cirrhosis of the liver. Therefore acid fermentation must be carefully avoided; and to prevent such fermentation in some degree in the stomach and in the intestine, it is necessary to masticate the food thoroughly, as will be shown.
Another very important organ, the sound condition of which is of great importance to the liver, is the pancreas. It has been found by several authors, particularly by Steinhaus,[188] in his investigation of some 40 cases of hepatic cirrhosis, that the pancreas is also affected in each case of this type; and we further know that after disease of the pancreas, as in diabetes, for example, the liver is also, as a rule, altered. Thus these two organs are in close relationship.
As pancreatic diseases are among the most difficult to diagnose, and people suffering from them live and die, as do also many diabetics, without their particular state having been recognized, so, the rational treatment of these diseases being still imperfect, we cannot offer advice in regard to their prevention. But, at any rate, the safest course will be moderation in diet, especially fatty food, which exacts the active co-operation of the pancreas. As in the case of all other organs, long-continued overwork will exhaust this gland, and thus induce a diseased condition. Moderation in diet will be the best policy for the pancreas, as also for the liver; and to maintain these organs in sound working order, meat in particular should only be taken in small quantities, and fat also should not be partaken of in large amount.
Milk and vegetable food, with but little meat, and that preferably as fish, will certainly furnish the best diet to avoid diseases of the liver. As Quincke[189] mentions, experience shows also that water in large quantities, especially certain alkaline saline waters, can increase the flow of the bile; and therefore, as also for other reasons mentioned in this book in Chapters XXXIV and XLI, water should be drunk in sufficient quantity every day. The alkaline waters referred to are certainly superior in their action to ordinary water, especially those kinds which at the same time cause purging.
Hot climates have a deteriorating effect on the liver. We have often noted the great frequency of liver complaints under these conditions, and we have never had a patient from the hot parts of Mexico who has not had a hypertrophied liver. We are inclined to believe that it is not so much the climate as faults in hygiene, especially in diet and in the use of stimulants, which are the cause of such a condition in Europeans residing in tropical climates.
A vegetarian diet is certainly the best in tropical countries, as we personally found during a stay in Southern Florida, Texas, and Mexico. Just as for the kidneys, so for the liver, a bath, and particularly a sweat-bath, is of great benefit, since by means of it toxic products may be eliminated which would otherwise be carried to the liver.
We have found these baths to be of great benefit in liver diseases, and considering the amelioration of the processes of oxidation brought about by such baths, it seems highly probable that they are capable of improving also the working condition of a liver not as yet diseased.
In general, it is our opinion that to prevent disease in an organ the surest method is to use those means through which that organ, when diseased, is found to benefit. Of course this is only meant as a general statement; but in the children of those suffering from liver complaints such preventive treatment is particularly indicated, as these conditions, we have found, are most frequently inherited. We have treated cases where three or four generations of one family had been sufferers from the same complaint.
Here, as always, let us follow the wise precept: “Prevention is better than cure.”