706 JAUNDICE. 



poisons. In occasional instances irritability of the bowels 

 exists, and defective movement of the right fore-limb. When 

 these serious s}Tnptoms continue unrelieved other organs may 

 become involved, and death result from the addition of such to 

 already existing serious anoemia and exhaustion. 



Treatment. — This must in great part be regulated by a con- 

 sideration of the conditions upon which the assemblage of 

 symptoms, known by the term of jaundice, depend. If these 

 can be discovered, an attempt must be made for their removal ; 

 when not possible of immediate removal their untoward results, 

 or the complications which attend them, must be carefully 

 watched and combated, while no endeavour is to be neglected 

 which may promote the general health and special tonic 

 efficiency. 



In many of the developments of those symptoms connected 

 with specific fevers, or when not of a severe character and un- 

 associated with any appreciable cause, the abnormal conditions 

 being frequently of an evanescent character, with a disposition 

 on the part of the animal functions to return to their normal 

 conditions, little or no treatment save light diet will be re- 

 quisite. 



When we have reason to suspect congestion and disturbed 

 hepatic action, the use of such agents as are believed to favour 

 the emptying of the canal, and afterwards of those which seem 

 to stimulate the formation of bile or favour its discharge, are 

 indicated. The chief of these are aloes, aloes with moderate 

 quantities of calomel or rhubarb, sulphates of soda and mag- 

 nesia, or muriatic or nitro-muriatic acid, given alone or alter- 

 nated with these salines. Many cases will be found to do 

 better with a moderate laxative first, the bowels being after- 

 wards kept soluble with the soda or magnesian sulphate. 

 While, when exhaustion and want of tone are marked, the 

 mineral acid may be used alone or combined with some prepa- 

 ration of quinine. 



In many, where weakness is extreme and following particular 

 fevers, I have found good to follow the free use of inspissated 

 ox-bile, given in bolus twice daily, with moderate doses of 

 aromatic spirits of ammonia between. Much of our success in 

 every case will depend on the proper adaptation of the remedies 

 to immediately inducing causes. 



