Liver Diseases
There are various diseases of the liver:
Liver Weakness (Za'f-e-Kabid)
When the liver becomes unable to perform its natural functions properly, it is called liver weakness. Important forms include:
1. Stimulation of the Nervous System, Breakdown of Glands, and Relaxation of Muscles:
In this condition, inflammation occurs in organs, leading to deterioration of glandular function and relaxation of muscles. As a result, the spleen, pancreas, and liver become weak and cannot perform their functions properly. They fail to produce and release their secretions efficiently into the blood, reducing the body's strength and affecting heart and muscle activity.
Other glands also fail to absorb bodily fluids properly, causing disturbances throughout the body and leading to acute symptoms such as colds and diabetes.
Causes:
Excessive use of hot and moist foods.
2. Stimulation of Muscles, Weakening of Nerves, and Suppression of Glands:
This condition causes inflammation of the stomach, resulting in abdominal pain, burning sensation, acidity, and excessive gas. Glands become sluggish and fail to release digestive juices properly, leading to poor digestion. Waste remains in the large intestine for prolonged periods, causing constipation because weakened nerves cannot effectively signal bowel evacuation.
Symptoms include:
Constipation
Dullness of the whites of the eyes
Heaviness of the head
Causes:
Excessive consumption of cold and dry foods.
3. Stimulation of Glands, Muscle Breakdown, and Nervous Depression:
The glands become overactive and release excessive secretions into the blood, even exhausting their reserves. These secretions become excessively "hot," causing breakdown of heart and muscle tissues. The nervous system becomes sluggish.
Symptoms include:
Constant fatigue
Lack of relief from sleep or work
Anxiety and restlessness
Pale complexion
Burning urination
Causes:
Excessive use of hot and dry foods.
Hepatitis
The term "Hepatitis" comes from two Latin words:
Hepa = Liver
Tis = Inflammation
Together, hepatitis means inflammation of the liver.
Modern science attributes hepatitis to viruses.
What is a Virus?
The word "virus" comes from Latin and means "poison."
Size of Viruses
Viruses vary in size, generally ranging from 0.01 to 0.3 micrometers (μm).
Shape of Viruses
Viruses may be:
Spherical
Rod-shaped
Polyhedral
Tadpole-shaped
Hepatitis-A
The HAV virus causes inflammation of the liver and intestines.
Symptoms
Loss of appetite
Abdominal pain after eating solid foods
Nausea and vomiting
Bitter vomiting
Headache/heaviness
Intestinal pain
Restlessness
Pain in the liver area
Constipation
Mild fever (99–100°F)
Enlarged liver and spleen
Jaundice after a few weeks
Dark urine
Reduced red blood cells
Skin itching and rashes
Weight loss
Causes (according to the text):
Excessive use of hot and dry foods
Environmental and climatic factors
Hepatitis-B
The text describes Hepatitis B as the most dangerous form because its virus is highly active.
Symptoms
Mild yellowing of the face
Dull eyes
Sunken facial appearance
Fatigue and weakness
Dark yellow urine
Loss of appetite
Constipation
Weight loss
Bleeding from body openings
Headache
Mild fever
Itchy skin eruptions
Abdominal pain after meals
Enlarged liver and spleen
Kidney inflammation
Excessive thirst
Pain beneath the ribs
Irritability
Palpitations
Rapid heartbeat
Shortness of breath
Body aches
White nails
Impaired blood clotting
The text also mentions a theory that iron accumulation may contribute to liver cell damage.
Causes (according to the text):
Excessive consumption of cold and dry foods
Improper treatment of malaria
Infected blood transfusions
Environmental factors
Hepatitis-C
Symptoms
Poor appetite
Fatigue
Body aches
Anxiety and obsessive thoughts
Bleeding from body openings
Pale nails
Yellowish-red palms
Impaired blood clotting
Reduced urine output
Liver tenderness
Runny nose and watery eyes
Weight loss
Constipation
Intolerance to solid foods
Acidity and heartburn
Dry stools and occasional rectal bleeding
Skin itching, rashes, and pimples
Pain beneath the ribs
Intestinal and kidney involvement
Low-grade fever
Dangerous Signs
Progressive liver destruction may lead to:
Fibrosis (scar tissue formation)
Shrinkage of the liver (cirrhosis)
Enlarged spleen
Low platelet count
Swollen veins in the esophagus (esophageal varices)
Fluid accumulation in the abdomen (ascites)
Vomiting blood
Black stools
Severe bleeding from ruptured varices can be fatal.
Causes:
Blood transfusions
Reused syringes
Contaminated razors
Dental instruments
Surgical equipment
Piercing needles
Jaundice (Yarqan Asfar)
Jaundice occurs due to the production and accumulation of Bilirubin. Under normal conditions, it is present in the blood at 0.2 to 0.8 milligrams per 100 milliliters. When it rises above 1.0, it is called Jaundice (Yarqan Asfar).
The cells of the hepatic parenchyma (Hepatic Parenchyma) do not play any role in the production of Bilirubin. These cells merely absorb this biliary pigment from the plasma and transfer it to the bile ducts, from where it goes into the intestines as required. Through this process, after separating from plasma proteins, it combines with glucuronic acid and takes the form of Mono or Diglucuronide. As a result, besides a reduction in molecular size, changes occur in its physical and chemical properties. In this state, it is called Chole Bilirubin.
Modern research has revealed that a small quantity of Bilirubin is produced during the formation of red blood cells. With an abnormal increase in the formation of red blood cells, there is also an increase in the proportion of Bilirubin produced through this source. Whether due to an increase in the production of Bilirubin or a decrease in its excretion, the amount of biliary pigment in the plasma increases. An increase in biliary pigment to the extent that it changes the color of the skin is called Jaundice (Yarqan Asfar).
Bilirubin is produced from the breakdown of red blood cells. This Bilirubin goes to the liver but is not excreted in the urine. It must first go to the liver, where it combines with a chemical compound and then becomes part of the bile. After this, it can also pass into the urine.
When Bilirubin enters the intestines, bacteria act upon it and break it down into several compounds. One of these is Stercobilinogen, which leaves the body with the stool. Some compounds are reabsorbed from the intestines into the bloodstream. One of these is Urobilinogen, which first reaches the kidneys and is then excreted with the urine. This is why urine is yellow in color.
Hepatomegaly (Enlargement of the Liver)
The liver enlarges for two reasons:
1. Stimulation of the nerves, degeneration of the glands, and relaxation of the muscles:
Since degeneration occurs in the glands during this state, they become enlarged, resulting in symptoms such as fatigue, a salty and bland taste in the mouth, nausea, and vomiting. Sometimes a slight fever develops. If the liver enlarges significantly, it can be clearly felt with the fingertips below the ribs on the right side, though it feels soft rather than hard.
Causes:
Excessive use of hot and moist foods.
2. Stimulation of the muscles, degeneration of the nerves, and suppression of the glands:
Since suppression occurs in the glands, they become swollen, and the patient experiences constipation, excessive intestinal gas, and small amounts of muddy, frothy stools. There is a feeling of heaviness over the liver region, occasional mild waves of pain, a sensation of needle-pricks, and severe fatigue throughout the body. Afterwards, fever develops and the liver continues to enlarge until lying on the right side becomes difficult for the patient. If not treated properly, numbness begins to occur in them, which is considered one of the signs of destruction.
Causes:
Excessive use of cold and dry foods.
Atrophy of the Liver (Shrinking of the Liver)
In this disease, damage occurs to the liver cells, and they attempt to repair themselves; often they recover, but sometimes they do not. Fibrosis and scar tissue develop in many parts of the liver. This fibrosis begins to narrow the blood vessels and bile ducts present in the liver, causing symptoms of atrophy to appear. Eventually, this disease turns into cancer. The major symptoms of this disease are:
Weakness, sunken cheeks, fatigue, weight loss, loss of appetite, nausea, vomiting, pain in the liver region, vomiting of blood, impotence in men, and cessation of menstruation in women. Sleep becomes reduced. In the early stages of the disease, the liver enlarges, but gradually it shrinks. Ascites may occur at any stage of the disease. The abdomen becomes swollen with fluid, and its skin appears dull and pale, with blue veins becoming prominent. The feet, tongue, and lips become swollen.
In cirrhosis, the portal vein, which carries blood from the intestines and stomach to the liver, becomes narrowed. When obstruction develops in it, pressure increases and causes increased pressure in other small veins of the stomach. As a result, varicose veins develop in the lower part of the food pipe (esophagus). These veins are very delicate. Due to the increased pressure, they may rupture and begin bleeding into the stomach, resulting in vomiting of blood and black stools. If a large amount of blood is lost suddenly, the patient's condition becomes critical.
Diagnosis of this disease becomes clear through endoscopy and ultrasound.
Causes:
Attack of a virus, alcoholism, improper treatment of hemorrhoids, and the use of Myrin-P (anti-tuberculosis medicines).
Ascites (Accumulation of Fluid in the Abdomen)
In this disease, blood serum transudes and accumulates beneath the skin or mucous membrane in spaces, cavities, or a body cavity, resulting in disease-specific symptoms.
There are three types:
1- Fleshy Ascites (Istisqa Lahmi):
Symptoms:
In this disease, due to the presence of blood serum in the skin and subcutaneous tissues, soft swelling, distension, and false edema occur. The body appears swollen and kneaded like leavened dough, and pressing a finger into any part of the body leaves a pit for a few seconds. Since the blood serum is present in a small quantity and spread throughout the body, the pit is very slight and disappears quickly. However, if the blood serum is present in a greater quantity beneath the skin, the pit is deeper and disappears more slowly. The irritation and edema begin in the feet and later spread to the abdomen and face. The complexion becomes white, greasy, and corpse-like. The stool is white, and the urine is also passed white. There is a complaint of flatulence, diarrhea occurs, the mouth tastes bitter, thirst is present, the navel is protruded, and the pulse is wave-like, broad, and soft.
In fleshy ascites, itching of the nose and edema of the face, body, or right hand is a grave sign. Physicians believe that such a patient is only a guest of two or three days. Likewise, if edema of the face, body, or right hand is accompanied by a complaint of salivation, the patient dies on the fifth day.
Causes:
Excessive use of hot and moist substances, poisoning.
2- Sac-like Ascites (Istisqa Zaqi):
Symptoms:
When the disease-producing matter is hot, the dissolved fluids of the muscles accumulate between the omentum and the peritoneum in the abdominal cavity, which is called sac-like ascites because the abdomen gradually swells like a waterskin and feels very heavy. By tapping the abdomen or changing the patient’s position, waves of fluid can be felt. A boggy sensation is also felt. On changing position, a depression appears in the upper elevated part. The skin of the abdomen is clear and stretched, and a kind of shine can also be seen on it. White streaks appear on it, the navel spreads out and its depression disappears. Except for the abdomen, all the other parts of the patient’s body show wasting and emaciation. The bones of the body become prominent. The ribs of the chest become especially visible. The face appears drawn, worried, and distressed. Circles appear around the eyes. The hands and feet become cold. Sometimes swelling develops in the face, eyelids, and penis. Water accumulates in the scrotum, and the navel protrudes. The urine is red and passed in small quantity. Sometimes it stops altogether. On undergoing ultrasound, a report of +++ Ascites is obtained, and CBC shows signs of low HB. Due to the pressure of the accumulated fluid on the diaphragm, difficulty in breathing and more or less coughing also develop.
In sac-like ascites, swelling of the testes and passage of bloody stool are very grave signs. Physicians believe that after the appearance of these signs, the patient generally does not recover but dies within a week. Likewise, if sac-like ascites develops in impure intermittent fever, half-intermittent fever, or persistent phlegmatic fever, and inflammation of the liver and inflammation of the spleen also occur, then the patient dies within seven to ten days.
Causes:
Excessive use of hot and dry substances, environment, season, climate, poisoning.
3- Tympanitic Ascites (Istisqa Tabli):
Symptoms:
Due to the formation of difficult-to-dissolve gases in the abdomen, the abdomen becomes distended. Sometimes a small amount of fluid is also mixed with the gases. There is distension, expansion, and severe flatulence in the abdomen. Heaviness is absent or very slight. On tapping the abdomen, a drum-like sound is heard. For this reason, it is called tympanitic ascites. The patient belches constantly. Relief is obtained through belching or passing wind. The intestines become prominent, and their vermicular movements can be felt. Percussion of the abdomen is tympanitic everywhere. The navel protrudes, and there is constant pain with twisting near it. Wasting of the organs begins to occur. Edematous changes do not develop in the legs. The pulse is long. In some patients, it is rapid, continuous, and inclined toward hardness and distension. The urine is red.
In this type of ascites, asthma, shortness of breath, and cough are grave signs. In such conditions, the patient generally dies on the second or third day. Likewise, ulcers of the mouth, ulcers of the gums, ulcers of the body, and diarrhea are also considered fatal.
Causes:
Excessive use of cold and dry substances.