64 THE LIVER. 



studded with patches of erosion. Next to this, is 

 the 



Duodenum, which is often found inflamed, thickened, 

 softened, indurated, or ulcerated, and in some cases 

 apparently scirrhous. Tumours also, of various kind?, 

 have been found imbedded in its coats at the place 

 where the biliary ducts empty themselves, which either 

 entirely obliterate these apertures, or very greatly 

 diminish them. 



Finally, the pancreas, spleen, and right kidney are 

 in some cases found considerably enlarged, and are the 

 seat of Scirrhus and many other abnormalities. 



" There are few disease ' 'opland, " the nature 



and morbid relations of which have occasioned ar, 

 diversity of opinions than Jaundice; and there, are it 

 may safely be averred few diseases the treatment of 

 which has created greater conflicts of opinion among 

 physicians. On these grounds it may in truth 

 that there are few diseases which require more discrimi- 

 nation as to the indications, the selection of the n-m.-dy, 

 and other means of cure than Jaundice. It proceeds, 

 as w< ly pointed out, in di:: -<, from 



s,. many different path from 



1 1 any combinations of them, that the closest attention 

 and practical acumen are necessary to ascertain an i 

 tinguish the morbid cond: 1 peculiarities of each 



individual ease, and to select the specific drug for their 

 removal. It is requisite not merely to guai 

 vascular excitement on the one hand, and vital depres- 

 sion on the other, but in many cases, also, to prevent 

 or to remove both, as being the more immediate causes 

 of the obstructed secretion or excretion of bile. In all 



