46 THE LIVER. 



exhaustion, sometimes by blood-poisoning, sometimes 

 from the so-called chokemic intoxication, and sometimes 

 by perforation, followed by peritonitis, or suppurative 

 inflammation of the substance of the liver. 



DIAGNOSIS. The diagnosis of Jaundice is on the 

 whole not a very difficult task, as its outward mani- 

 : tions present so many features which are indicative 

 of the complaint ; such as the yellow tint of the con- 

 junctiva; and skin ; the pale clayey faeces and saffron- 

 coloured urine, which stains the linen of the same colour ; 

 the slow pulse and itehiness of the skin. Moreover, the 

 urine may easily be examined by the usual tests, so 

 detect witli certainty any bile-pigment which may be 

 present. Hut tin- real difficoitiesin diagnosing this disease 

 " if it may be so called" commences when we come to 

 determine the cause, and apply a suitable mode of ; 

 nirnt to each particular case. Moreover, it is incum- 

 bent on the physician to be very guarded in his 

 pn>i;no<is of this mmphiint, as it depends principally 

 upon its causes. The natural course and modes of 

 minatioii of the primary disease, ami i : less 



probability there is of interferini: with 

 of treatment, constitir .inch 



alone will enable ;;I:I>KT the result. A correct 



knowledge of each particular case furnN \vith 



^rounds for a correct "prognosis" at once, and nly 

 \vheiv this is impossis . i; tin in doubt 



as to the result. It must, however, be borne in mind 

 that there are cases of app lu Jaundice, 



without any perceptible ase of the liver, 



where symptoms of blood-poisoning .sometimes make 

 their appearance suddenly and quite unexpectedly ; 



