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Jaundice.Cause.-This yellowness is due to the presence of the bile or some of its constituents in the blood. The bile is formed in the liver and should pass out through the gall duct into the intestine. A failure on the part of the liver to form the bile, or the presence of some obstruction in the gall duct, which prevents the escape of bile into the intestine, is followed by the appearance of this yellow coloring matter in the blood and the consequent yellowness of the skin through which the blood circulates in large quantity. The first of these causes, the failure of the liver to perform its functions properly and secrete the bile, usually occurs during some of the infectious diseases, or in consequence of a disease in the liver itself. Thus some of the diseases which follow surgical operations-septicæmia and pyæmia, for example-are not infre quently accompanied by a decided yellowness of the skin. Inflam mation of the liver itself may be associated with the same symptom. It would seem also that the action of various agents directly upon the blood may cause jaundice, without affecting the liver itself. Thus this yellow color has been observed after the long continued inhala tion of chloroform, from the bite of venomous serpents, from violent mental emotion, grief, fear or anger; and it sometimes occurs, without apparent cause, in those who have long resided in malarial districts. But the most frequent and usual causes of jaundice are obstruc tions somewhere in the channels through which the bile flows in its passage to the intestines. The most frequent condition is probably a catarrh of the stomach and intestine, the condition described as " biliousness," whereby the gall duct becomes swollen and closed. Another frequent obstruction is the presence of gall stones, de scribed on a previous page. Symptoms*-The most prominent symptom is the yellow tinge which becomes visible first in the whites of the eyes, and then ex tends over the face, neck and chest. It is apt to be accompanied by an annoying itching or tingling sensation. The perspiration is usually tinged with it, and may therefore stain the body linen. The urine acquires a dark brown color, which may deepen almost to black if the jaundice be intense. In this case it usually deposits a heavy sediment. At times the stools are a slate color or almost white. The symptoms manifested by the alimentary canal vary in different cases according to the condition which causes the jaundice. In most cases there is a bitter taste in the mouth; the tongue is heavily coated, and there is apt to be a feeling of nasuea, perhaps even vom iting. There may be also decided depression of spirits and indis position for exertion. Jaundice may exist for a considerable time without giving rise to other than the symptoms already noted. In many cases the patient remains sufficiently strong and active to attend to his usual avocation. The duration and ultimate outcome depend, of course, upon the condition which induces the jaundice. If this be a catarrh of the stomach and intestine, as is often the case, the color usually disap pears from the skin in from two to four weeks, the other symptoms subsiding even earlier. If the jaundice be due to the presence of a gall stone obstructing the gall duct, the duration of the discoloration may be much greater. Cases are known in which such obstruction of the gall duct and consequent jaundice have persisted for years without materially impairing the nutrition of the body. Yet in most instances the general health fails, the patient becomes emaci ated, and death finally results. Treatment.-In every case the object is, of course, to remove the cause of the jaundice. Hence the treatment must necessarily vary according to the supposed cause. In most cases a few doses of podophylline may be administered to advantage-a quarter of a grain morning and night ; or two grains of calomel in powder may be given at night, followed by ten or fifteen grains of the bicarbon ate of soda in the morning. Yet no time should be lost in endeav oring to discover the source of the difficulty, and direct treatment to the removal of this source. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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