DISEASES OF THE SOLID ORGANS OF THE ABDOMEN 89 



JAUNDICE. 



The presence of biliary coloring matter in sufficient quantity to give a 

 yellow color to the skin, constitutes the diseased condition known as 

 icterus or jaundice. Strictly it is never an individual affection, it being a 

 symptom, and incidental to various disorders. 



Jaundice often appears when its cause cannot be clearly determined; 

 again, it is an important morbid condition, convenience in considering 

 which demands special recognition and classification. In considering it 

 as an individual disease, cases are to be excluded in which it occurs with 

 an affection, the existence of which is clearly determined. 



In acute and chronic hepatitis and certain constitutional diseases it is 

 to be regarded merely as a symptom. 



Causation.— \\\ a great majority of cases jaundice depends on obstruct- 

 ion of the passage of the bile to the intestine. 



From obvious facts it is reasoned that more commonly the bile is reab- 

 sorbed after the secretion of it has taken place. Defective secretion how- 

 ever, either with or without obstruction doubtless occurs, and the constit- 

 uents of the bile accumulate in the blood if not thrown out by some 

 unusual channel. 



It is conjectured that more or less of those indefinite symptoms which 

 are commonly included under the name "biliousness," are due to a defi- 

 cient elimination of the bile or at least one of its elements. 



The more apparent exciting causes are over fatigue, the indiscriminate 

 use of powerful emetics and cathartics, indigestion, obstinate constipa- 

 tion, traumatic injuries, and sudden chills. 



When the functions of the skin are arrested by cold there are two ways 

 in which disease is supposed to be produced. One relates to the circula- 

 tion ; the blood being driven from the surface accumulates in the internal 

 organs inducing congestion. 



The other method of action relates to the increased activity demanded 

 of certain organs, to compensate for the deficient elimination of the skin. 

 It is to be remembered that the skin is an important medium, through 

 which matters proper to be evacuated from the body are expelled. Again 

 any material change in the condition of the skin affects the perspiration, 

 the office of which is principally to regulate the temperature of the body. 



Thus it will be seen that disease may not infrequently originate from the 

 action of cold applied to the surface of the body, as in sudden immersions 

 in water and too rapid cooling after a hard run; the radical and rapid 

 changes of temperature being the most active. 



Some authors include fighting and prolonged sport among the causes of 

 jaundice. While the direct action of these influences is unexplained, it 



