214 Retrogressive Processes. 



access to all the glands their secretions also become yellowish ; 

 and the pigment is especially noticeable in the urine. [The 

 saliva, gastric and pancreatic juice, tears and mucus are apt 

 to be free from coloration.] Only cartilage, the cornea and 

 the enamel of the teeth, and, too, the brain, take up but little of 

 the color. Because of the diffuse uniformity of impregnation 

 of the intercellular substance and of the cells with the coloring 

 matter, it at times is not noticeable under the microscope (per- 

 haps washed away in the details of preparation of the specimen) ; 

 but in other instances some of the cells, as those of the liver, are 

 stained an intense yellow or yellowish-brown, and granular and 

 coarser deposits of a yellow, brownish or green color are found 

 in the protoplasm, especially in the hepatic and renal epithelial 

 cells. The pigment is sometimes seen in crystalline form (ruby- 

 red rhombic plates of bilirubin) in the kidneys, spleen and bone 

 marrow. 



Jaundice may be a transitory condition ; the liver after removal 

 of the interference to the passage of the bile resuming its 

 normal functions and the resorbed bile being eliminated by the 

 urine, etc. In case of more prolonged duration faults of the 

 organism become apparent. In the first place the absence of a 

 sufficient amount of bile in the intestine may interfere with diges- 

 tion; in the second place the bile stasis in the liver may cause 

 pressure upon the liver cells and can give rise to degenerative 

 and necrotic changes ; thirdly the mingling of the bile with the 

 blood brings into the latter and into the different organs sub- 

 stances which are haemolytic and have other toxic influences. 

 The biliary coloring matter and, too, the biliary acids are to be 

 included among such toxic substances, the latter undoubtedly being 

 toxic to the nervous system. [It is supposed that the itching 

 complained of by jaundiced human beings, and to some extent 

 present in animals, is due to an irritation of the skin by the 

 biliary pigment ; and the slowing of the cardiac rate in jaundice 

 is directly referable to the action of the biliary acids or their salts 

 upon the vagus, or in marked instances upon the heart itself.] 

 Moreover, the influence of substances produced in intestinal putre- 

 faction should be kept in mind, these materials being absorbed 

 from the intestines and passed through the diseased liver which 

 is no longer able to neutralize their poisonous properties. Severe 

 cerebral symptoms developing in cases of biliary obstruction and 

 sometimes fatal (convulsions, coma, delirium), accompanied by 



