in flannel pyjamas, and with a thin blanket drawn over his abdomen; during the day he wears a woollen undervest and very likely serge or thin tweed clothes. He does not sit down in damp clothes, and he has a great respect for a shower of rain. Besides chill, there are other causes which may convert the hyperæmia into congestion or inflammation; a blow may operate in the same way, so may a surfeit of eating or drinking, so may exposure to the sun, so may an attack of malarial fever or of dysentery.
Treatment.— Nature sometimes effects a cure in these cases of hepatic congestion by establishing a smart diarrhœa. In the treatment of such cases we cannot do better than to imitate Nature, and even to supplement her efforts. A few doses of the sulphates, in the shape of some kind of bitter water or of Carlsbad salts, generally give prompt relief. But if the subject of such attacks does not profit by experience and mend his ways, very likely his liver, in time, will become chronically hyperæmic and extremely liable to intercurrent attacks of congestion of a character more or less acute. The subjects of this type of " liver " ought to be most careful in their habits. They must not lie abed too long; they must not take cold baths; they must not take cold drinks, nor expose themselves to cold in any form; they must clothe warmly; and they must eschew alcohol in every shape. Animal food they must partake of but sparingly; and they should give the preference to fowl and fish over beef and mutton. Fruit and farinaceous food may be more freely partaken of, but over-eating in every form must be avoided. Exercise should be taken at least twice a day; and, at least once in twenty-four hours, the exercise should be of such a character as to provoke perspiration. A gallop on horseback, a smart game of tennis or rackets, are excellent hepatic stimulants. Occasionally, once a week or not so often, particularly when a sense of fullness or aching in the right side seems to indicate that all is not right with the liver, a dose of Carlsbad salts or bitter water, preceded perhaps by a few grains of calomel, may avert more serious trouble.
