508 Jaundice. 



It is diflScult to (leiiionstiate bile pigments in horse's urine. Highly 'liUited 

 urine gives Gmelin 's reaction but the green tint is lor the most part obscured by 

 a deep brown color. Latschenberger advises that the diluted urine be mixed with 

 baryta water and allowed to stand for from 12 to 44 hours, Gmelin 's test being 

 applied to the clear supernatant liquid. According to Bierthen, bilirubin cannot 

 be demonstrated in horse's urine, while in the majority of cases Gmelin 's test is 

 positive. 



Bile-pigiiients tend also to make tlieir appearance in sweat, 

 milk, and exudates, but they are completely absent from the 

 lacrimal secretion and the saliva. 



As a result of obstruction of the bile-duct the intestinal 

 contents contain little or no bile, and are therefore either pale 

 yellow or gray in color and contain a large quantity of fat. 

 In pleiochromic jaundice, on the other hand, the intestinal con- 

 tents are stained yellow with bile. 



In many cases the bile circulating in the blood produces 

 functional derangement in other organs. Affected animals 

 often appear dult and sleepy, and if moved show signs of fa- 

 tigue. The pulse is slower and sometimes irregular. The ap- 

 petite is lost. 



Where the jaundice is long-standing the animal loses con- 

 dition to a marked degree, and finally there may be complete 

 exhaustion. Before death pronounced nervous symptoms make 

 their appearance. There may be complete loss of consciousness. 

 In some cases there are localized or general cramp-like con- 

 tractions of the muscles. Occasionally the animals become de- 

 lirious, and during the attacks of delirium the breathing is 

 labored and sometimes of the Cheyne-Stokes type. Sometimes 

 severe cases of this sort have a sudden, fatal termination. 



Such cases occur especially in dogs. The cause is eitlier complete cessation of 

 the flow of bile owing to impaction or twist of the duodenum, compression of the 

 bile ducts by tumors of the pancreas or by enlargement of the spleen, poisoning by 

 phosphorus or salt, or acute yellow atrophy of the liver. As the actual cause of 

 the symptoms many authors believe that the large quantity of bile acids circulating 

 in the blooil has a direct effect on the nerve centers, and at the same time causes 

 fatty degeneration of the renal epithelium, whereby their excretion with the urine 

 is hindered (Leyden). It has not been possible, however, to produce these symptoms 

 experimentally by the introduction of bile acids into the body. The probability is 

 that the symptoms are caused by a diminution in the toxin-binding power of the 

 liver, which may have been either originally diseased or may have become so owing 

 to engorgement with bile. 



Kohnhauser has observed five cases of typhoid jaundice in the dog. The symp- 

 toms were as follows: dullness, inappetence, vonnting, accelerated pulse, temperature 

 up to 41° C, shallow and painful respiration, yellow discoloration of the nuu'ous 

 membranes, feces small in amount and pale yellow in color, bile pigments in the 

 urine and intense thirst. Later the jaundice became more intense and the animals 

 enntted an unpleasant sweet odor. In two cases there were edematous swellings. 

 The animals died in from 3 to 6 days from complete exhaustion. (Jhieri has re- 

 corded an outbreak of similar cases in which he believed the cause to be a general 

 infection with colon bacilli. It is possible that these were cases of hemoglobinenua 

 due to piroplasma with secondary jaundice. 



Course. The prognosis is most favorable when the cause 

 of the jaundice is catarrh of the duodenum or large bile ducts. 

 Occasionally gallstones produce a temporary jaundice. Acute 

 and chronic diseases of the liver parenchyma and chronic in- 



