When there are stitching pains in the right hypochondriac region, **Bryonia is the first remedy to be thought of, though for these pains we have other remedies, such as **Chelidonium and Kali carbonicum. Under **Bryonia the liver is swollen, congested and inflamed; the pains in the hypochondriac region are worse from any motion, and better from lying on the right side, which lessens the motion of the parts when breathing. It is one of the chief remedies for jaundice brought on by a fit of anger. **Chamomilla has this symptom, but the **Chamomilla patient gets hot and sweats, while the **Bryonia patient is apt to be chilly, though he appears hot. There is a bitter in the mouth and the stools are hard and dry, or, if loose, papescent and profuse and associated with a colic. **Berberis has stitching pains from the liver to the umbilicus. **Chelidonium is distinguished by the character of the stools.
**Bryonia is pre-eminently a gastro-hepatic remedy, and has pain in right shoulder, giddiness, skin and eyes slightly yellow. Hughes says it hardly reaches true hepatitis.
This remedy has much sensitiveness and dull pain in the region of the liver; the patient cannot lie on the right side. The liver is enlarged. The skin and conjunctiva are jaundiced. The stools are either clay-colored from absence of bile, or yellowish-green bilious stools passed with a great deal of tenesmus. There is a yellowish white coated tongue which takes the imprint of the teeth and there is a foetid breath, loss of appetite and depression of spirits. **Leptandra has aching and soreness in the region of the liver and is especially indicated in the lazy livers of city men; but is distinguished from **Mercurius in the stools, which are pitchlike and black, accompanied with no tenesmus, but rather a griping and the pains of **Leptandra are dull, aching and burning in the posterior part of the liver. The character of the diarrhoea will also distinguish **Mercurius from Magnesia muriatica, which is useful in the enlarged livers of puny and rachitic children. **Mercurius is the remedy for jaundice arising from abuse of quinine when fever is present. It is a splendid remedy for “torpid liver.” It suits well simple jaundice in children. Cowperthwaite believes that, as a rule, **Mercurius dulcis 2X is the most effective preparation of mercury in catarrhal jaundice.
The principal use of **Podophyllum is in liver affections. Primarily, it induces a large flow of bile, and, secondarily, great torpidity, followed by jaundice. It is indicated in torpid or chronically congested liver, when diarrhoea is present. The liver is swollen and sensitive, the face and eyes are yellow and there is a bad taste in the mouth. The tongue is coated white or yellow and the bile may form gall stones. There is a loose watery diarrhoea, or if constipation be present the stools are clay-colored. It somewhat resembles **Mercurius; it is sometimes called “vegetable mercury.” There are a number of drugs having the symptom that the tongue takes the imprint of the teeth, namely; **Mercurius, Podophyllum, Yucca, Stramonium, Rhus and Arsenic.
Another symptom of **Podophyllum is that the patient constantly rubs the region of the liver with the hand. Functional torpor of the portal system and the organs connected there with indicates **Podophyllum. There is constipation, clay-colored stool, jaundice and langour.
The liver symptoms of **Chelidonium are very prominent. There is soreness and stitching pains in the region of the liver, but the keynote for this drug in hepatic diseases is a pain under the angle of the right shoulder blade, which may extend to the chest, stomach, or hypochondrium; there is swelling of the liver, chilliness, fever, jaundice, yellow coated tongue, bitter taste and a craving for acids and sour things, such as pickles and vinegar. The stools are profuse, bright yellow and diarrhoea; they may be clayey in color. It is remedy to be used in simple biliousness and jaundice, and in hepatic congestion or inflammation the character of the stools will distinguish **Bryonia. Taken altogether, **Chelidonium is perhaps our greatest liver remedy; it causes the liver to secrete thinner and more profuse bile than any remedy; it is a useful remedy to promote the expulsion of gall stones, and to prevent their formation. It was Rademacher’s great remedy for gall stones, and Cowperthwaite finds it his best remedy. In simple catarrhal jaundice it is often all sufficient. It affects the left lobe of the liver much less than does **Carduus marianus.
When jaundice arises from cardiac diseases, **Digitalis may be the remedy. There is no retention of bile, nor obstruction of the ducts, but the jaundice is due to the fact that the liver does not take from the blood the elements which go to form bile. There is present drowsiness, bitter taste, soreness, enlargement and bruised feeling in the region of the liver. **Sepia has the yellow sallow face with the yellow saddle across the nose, with stools of bright yellow or ashy color. **Digitalis is useful in the worst forms of jaundice if the pulse be irregular and intermittent, and if there be rapid prostration of the strength.
Myrica cerifera. [Myric]
**Myrica is an important liver remedy. There is first despondency and also jaundice due to imperfect formation of bile in the liver, and not to any obstruction, comparing here with **Digitalis. There is dull headache, worse in the morning, the eyes have a dingy, dirty, yellowish hue, the tongue is coated yellow. The headache is worse in the morning. The patient is weak and complains of muscular soreness and aching in the limbs; there is slow pulse and dark urine. It is more superficial in action than Digitalis. The jaundice calling for its use is catarrhal and this is the form produced by the drug. The throat and nasal organs are filled with an offensive, tenacious mucus. Dull pain in right side below the ribs, no appetite, and desire for acids; unrefreshing sleep.
Nux vomica. [Nux-m]
In liver affections occurring in those who have indulged to excess in alcoholic liquors, highly seasoned food, quinine, or in those who have abused themselves with purgatives, **Nux is the first remedy to be thought of. The liver is swollen hard and sensitive to the touch and pressure of clothing is uncomfortable. The first remedy in cirrhosis of the liver. Colic may be present. Jaundice induced by anger also calls for **Nux vomica, also jaundice from abuse of quinine, in the former cases reminding of **Chamomilla, which is an excellent remedy for biliousness of nervous, irritable women. In the enlarged liver of drunkards, **Sulphur, Lachesis, Fluoric acid, Arsenic and Ammonium muriaticum must also be borne in mind, together with **Nux. Juglans cinerea causes a jaundice like Nux vomica, with stitching pains about the liver and under the right scapula, bilious stools and occipital headache. **Nux must be compared with **China, Pulsatilla in liver affections from over-eating.
**Iris seems to have a solvent action upon the bile, it is especially useful in torpid liver and when gastric disorders result from perversion of hepatic and intestinal functions. Jaundice and constipation.
**Aloes has biliousness from torpor of the portal system, distension of the liver, bitter taste and jaundice.
**Lycopodium acts powerfully on the liver. The region of the liver is sensitive to the touch, and there is a feeling of tension in it, a feeling as if a cord were tied about the waist. Cirrhosis. The pains are dull and aching instead of sharp and lancinating, as under **Chelidonium. Fullness in the stomach after eating a small quantity. There are no real icteric symptoms, but there is a peculiar sallow complexion. **Natrum sulphuricum is useful when the patient has a bad, slimy taste in the mouth and “thinks he is bilious.” There is apt to be weight and aching in the liver; he can lie on that side, but on turning to the left side the liver seems to pull and draw. **Natrum sulphuricum is the greatest Schuessler specific for liver affections, and clinically it has often worked well. Dr. Alfred Pope claims that **Lycopodium is more useful than any other remedy in old hepatic congestions. Pain in back and right side from congestion will often yield to the remedy.
Carduus marianus. [Card-m]
This remedy is indicated in jaundice with dull headache, bitter taste, white tongue with red edges, nausea and vomiting of a greenish fluid. There is an uncomfortable fullness in the region of the liver, the stools are bilious and the urine golden yellow; there is sensitiveness in the epigastrium and right hypochondrium. Burnett regards a dark brownish patch over the lower part of the sternum as a useful hint for **Carduus, and in such cases he observes that both the liver and heart are at fault. The presence of “liver spots seems to be a special indication for the remedy. Biliousness following la grippe has been cured with Carduus. Hydrastis has a bitter taste and chronic torpor of the bowels, lack of appetite, coated tongue and yellow urine. **Carduus resembles **Aloes. Hale says that it stands between **Aloes and **Hamamelis in its action on the veins. It has been used in gall stone colic successfully in the tincture, and it deserves a trial before restoring to opiates.