376 THE TREATMENT OF DISEASES. 



yellowish from sallowness, you have only to looir. at the whites of the eyes and the 

 urine, both of which betray the yellow tint of jaundice very early and conclusively. 

 The greenish-yellow colour of countenance observed in that form of anaemia called 

 chlorosis (see ANAEMIA) might, on a superficial examination, be mistaken for jaundice. 

 The slightest attention would serve to rectify the error, for in that complaint the 

 whites of the eyes are even whiter than natural, and the urine is normal in appear- 

 ance. In cancer, and other wasting diseases, the skin often assumes a greenish- 

 yellow, or lemon-coloured, waxen appearance ; but here again the whites of the eyes- 

 have the proper colour. A dusky yellowish tint of the surface is not unfrequently 

 seen in persons who have suffered much from ague ; and sometimes also in those 

 whose systems have been poisoned with lead ; but this need never be confounded 

 with jaundice. Jaundice has been successfully feigned by soldiers and sailors 

 desirous of obtaining their discharge. The yellow colour of the skin has often been 

 simulated by painting it with infusions of saffron, turmeric, rhubarb, broom-tops, or 

 soot ; whilst the colour of the urine has been heightened by taking rhubarb or santo- 

 nine. The point that puzzles these gentlemen is that they cannot make their eyes 

 yellow they remain persistently white. Moreover, they cannot stand being washed ; 

 a little soap and water, or better still, a weak solution of chloride of lime in water, 

 at once cures their jaundice and reveals the imposition. 



The colour of the skin in jaundice varies in different people. The young, and those 

 who are pale and fair, present a bright lemon colour. In those who are florid, or 

 whose cheeks and skin are flushed with fever, the tint will more resemble that of a 

 Seville orange. If the patient be naturally swarthy, or if his visage be livid or 

 dusky through imperfect action of the heart and lungs, the super-addition of jaundice 

 will give him a greenish, or olive hue. In old age the colour is usually less livid. 

 Sometimes, in very bad cases of jaundice, the face becomes quite dark in colour, con- 

 stituting green or black jaundice. Even in the same person the intensity of the 

 colour may vary from day to day, according to the diet, the amount of bile secreted 

 by the liver, and the activity of the bowels and kidneys. The colour of jaundice 

 often remains in the skin for some time after the cause has been removed, and it is- 

 important to know this with reference to treatment. It is useless in such a case to 

 continue the administration of medicines which act on the liver, but the departure of 

 the colour may be expedited by warm baths, and drugs acting on the bowels and skin. 



Often enough in jaundice the perspiration is coloured by the bile, so that it 

 stains linen yellow. Sometimes the saliva and tears have been found to be similarly 

 affected. Sometimes the milk is tinged, whilst at others it is not. In one case, a 

 woman with deep jaundice suckled her baby for six weeks without imparting to it a 

 yellow colour, or affecting its health in any way. 



Derangement of digestion is nearly always associated with jaundice. It generally 

 takes the form of flatulence, or wind, and constipation. In jaundice the bowels are 

 nearly always most obstinately confined. Naturally the bile acts as a kind of 

 stimulus to the intestines, and when it is not secreted in the proper way, there is 

 nothing to make them act. People in jaundice often suffer greatly from the hard- 

 ness of the motions. They strain and strain, and yet are unable to pass anything, 

 This difficulty may be the starting point of piles. 



