MODERN PHYSIOLOGIC CONCEPTS

Abstract

Treatment of hepatic disease until recent years was largely symptomatic. Diets low in all constituents were prescribed to spare the diseased liver as much as possible. As ascites was often the first clinical manifestation of chronic hepatic disease, the attack was primarily against this by means of purges, restriction of fluid and salt and, in more recent times, the administration of acid-forming salts and organic mercurial diuretics. Undoubtedly much damage was done by the enthusiastic therapeutist. Little attention was given to methods of supporting the liver, and little was known of the factors leading to ascites. In the twenties attention began to be directed to the condition of the liver based on new knowledge of its physiology and the experimental production of hepatic disease. Since then progressive changes in therapeutic practice have occurred. Results remain difficult to evaluate, but a scientific clinical approach has been developed. In an attempt at