Jaundice, Icterus, the Yellows. 467 



stomach in which the agent lay without being absorbed. In- 

 travenous injection might successfully meet such a case. The 

 well known action of potassium iodide as a mild antiseptic, as a 

 chemical antidote of the toxins of certain cryptogams, as a nervous 

 sedative, and as an eliminating agent, would help to explain its 

 curative actions. 



A still later resort to large doses of sodium bicarbonate in this 

 disease equally suggests the value of elimination, and of a 

 markedly alkaline treatment. 



JAUNDICE, ICTERUS, THE YELLOWS. 



Symptoms. Causes: Mechanical obstruction of bile duct, gallstones, 

 hydatids, distomata, extraneous bodies, inflammation, stricture, oblitera- 

 tion, absence, ulceration, spasm, tumor, enlarged lymph glands, gastric 

 tumors, pancreatic, kidney or omental tumor, aneurism, faecal accumula- 

 tion, pregnancy, ovarian tumor : Without mechanical obstruction, ptomaines 

 and toxins, animal venoms, mineral poisons, hepatic atrophy, fear, other 

 emotions, cerebral concussion, imperfect oxidation, excess of bile, hepatic 

 inflammation, constipation and reabsorption of bile, experimental jaundice, 

 balance of tension in gall-ducts and blood vessels, duodenitis, compression 

 of aorta, haematodin and bilirubin, destruction of blood globules by hydro- 

 aemia, taurocholate of soda, chloroform, ether, freezing, heat, electricity, 

 alkalies, nitrites. Haemoglobin : Its solubility in horse. Bile acids and 

 blood pigment. Summary of causes. Gravity of icterus. Symptoms: Col- 

 oration, yellow, orange, brown, of tissues of secretions : Tests, staining white 

 paper, Gmelin's test, nitric and sulphuric acids, rainbow hues : Pettenko- 

 fer's test for bile acids, syrup and sulphuric acid, dark violet : Stranburg's 

 test syrupy paper and sulphuric acid, dark violet ; clay colored foetid stools ; 

 gravity. 



The terms icterus and jaundice are applied to a yellowness of 

 the mucosae, urine, skin and tissues caused by the presence in 

 them of the coloring matters of bile. The condition is a symp- 

 tom of many different affections rather than a disease per se, yet 

 the phenomenon is so characteristic that it has been hitherto 

 accorded a special place and article in systematic works. 



Jaundice is either associated with mechanical obstruction of the 

 bile duct or ducts, or it is independent of such obstruction. The 

 following enumeration of its causes slightly modified from Mur- 

 chison, is equally applicable to the lower animals as to man : 



