JAUNDICE. 47 



death, as a general rule, invariably supervenes in such 

 cases. Under these circumstances, the physician cannot 

 be too guarded as to how he gives an opinion even in 

 apparently TRIVIAL cases. 



About six years ago I attended a gentleman who 

 had resided for some years on the southern slopes of the 

 South American continent. He returned to England 

 invalided. He had, previous to my seeing him, consulted 

 several medical men in London of the homoeopathic 

 school, who treated him for dyspepsia. I diagnosed 

 abscess of the liver, which was confirmed by my friend, 

 Dr. Vaughan Hughes. Shortly after this, alarming symp- 

 toms set in; the relatives suggested another opinion, 

 and one of the city magnates was selected. We met in 

 consultation, and to my utter astonishment he repudiated 

 all idea of hepatic abscess, and gave a favourable 

 prognosis ; in three more days my patient was a corpse. 

 A post-mortem, however, revealed an enormous abscess 

 in the right lobe of the liver, having one communication 

 with the stomach, and another with the right thoracic 

 cavity of recent origin. This case will be fully recorded 

 when I come to treat on the more serious and malignant 

 : s'S of the liver. 



C.\ - TUKATMKNT OF JAUNDICE. In the treat- 



ment of Jaundice the first and most important point to 

 be considered is the various causes which have led to 

 .u-cuiiiulation of bile-pigment in the blood ; the 

 removal of these necessitates no further treatment against 

 i.tundice itself, for let it be clearly understood that 

 Jaundice per se is not a disease, but merely a symptom 

 ;h ; remove the cause, the icteroidal phenomena 

 disappear. 



