JAUNDICE. 375 



However bad the itching may be you should avoid taking laudanum or opium in 

 any form. You may possibly get a night's rest, but you pay for it in the long-run, 

 and are almost sure to be worse the next day. When the irritation is so very- 

 great that the patient is almost worn out by want of sleep, a mechanical mode of 

 treatment may be resorted to. Get a plug of bone made shaped like the nipple of 

 an infant's feeding bottle, and furnished with a circular shield to prevent it from 

 slipping into the bowel ; the nipple should be about an inch and a half in length, 

 and as thick as the end of the forefinger. This is introduced into the back passage 

 at bed-time, and retained all night. It is most efficient in preventing the nocturnal 

 itching, and a good night's rest is almost sure to result from its use. It is 

 recommended, however, that it should be worn only every other night. The idea 

 of this plug was first suggested by noticing the fact that many patients can obtain 

 relief and sleep, when the itching is very bad, only by introducing the end of the 

 forefinger into the bowel and making pressure. 



Itching occurring about the front passage in women is usually successfully 

 treated by one of the applications we have mentioned above. The calomel ointment 

 is especially useful, but in obstinate cases it may be necessary to resort to the 

 employment of leeches or blisters to the inner side of the thighs. A strong solution 

 of alum applied several times a day often succeeds when other things have failed. 

 It must not be forgotten that this complaint may depend on irritation of the womb, 

 and the treatment may have to be directed to this organ. 



JAUNDICE. 



Jaundice occurs as a symptom in the course of many diseases of the liver. It 

 may depend upon various, and very different morbid conditions, the nature of which 

 in any given case is often involved in obscurity. 



The word jaundice is derived from the French, jaune, yellow. Its technical 

 appellation is icterus, the Greek name for a bird with a yellow plumage, the Galbula, 

 or golden thrush, the sight whereof by a jaundiced person was said to be death to 

 the bird, but recovery to the patient. The Latins called it morbus arquatus, from its 

 exhibiting some of the bright hues of the rainbow, and aurigOj from its resembling 

 gold. Even now-a-days we speak of a person being as yellow as a guinea. 



There is never any difficulty in recognising the presence of jaundice, at all events, 

 when well marked. You have only to look at your patient in daylight to see 

 what is the matter with him. By candle or gaslight the yellowness of the skin is 

 readily overlooked, and often cannot be detected at all. The symptoms constituting 

 jaundice may be said to be yellowness of the skin and of the eyes, whitish or 

 drab-coloured motions, and urine having the colour of saffron, and communicating a 

 bright yellow tinge to white linen. There are other symptoms to which we shall 

 have occasion to refer presently. The characteristic yellow complexion of jaundice 

 is owing to the presence of bile in the blood. The deep tint of the urine is evidently 

 derived from the same source. The paleness of the motions is ascribed to the absence 

 of the bile which always exists in natural and healthy excrement. 



If .there is any doubt as to whether the patient is really jaundiced, or on^y 



