THE LIVEE. 539 



th3 characteristic tinge of jaundice. The bile is finally excreted by the 

 kidneys, and to a small extent by the skin. 



Jaundice is a state of the body in which most of the tissues and fluids 

 become stained by the colouring matter of the bile. All cases of true 

 jaundice resolve themselves into jaundice from obstruction, when, as we 

 have just seen, the bile is prevented from getting into the small intestine. 

 Murchison held that jaundice might take place when there is no obstruction, 

 but from some cause, such as an excessive secretion of bile, especially when 

 conjoin-ed with constipation, by which this fluid, having gained access to 

 the intestine, is not changed into new products, as it ought to be, but 

 becomes absorbed into the blood, and consec[uently stains the skin and 

 other tissues. 



The depression and debility experienced in jaundice may, to some extent, 

 be owing to the presence in the blood, of bile acids, which destroy the red 

 corpuscles. It is, however, more probable that they are due to the re- 

 tention, in the blood, of various impurities, which the liver, when it is in 

 a diseased state, is unable to transform^ with sufficient quickness, into 

 products which the kidneys can readily remove ; for we find that the 

 injection of bile into the blood gives rise to no special symptoms of 

 depression. The fact of the various tissues being stained with the colour- 

 ing matter of bile does not, in all cases, imply the existence of debility ;> 



PBINOIPLES OF TREATMENT.— To relieve the congestion of the 

 vessels of the liver, and also to get rid of noxious materials contained in 

 the blood, we may use a purgative, the effect of which will be to draw 

 blood away from that organ to the intestines, and, also to cause the evacua- 

 tion from the blood of a quantity of its watery fluid, which holds the hurt- 

 ful materials in solution. The best aperient is sulphate of magnesia (Epsom 

 salts). Its action should be assisted by keeping the horse on laxative food, 

 such as bran mashes, roots, and green fodder. Two or three enemas of 

 warm water, in order to clear out the rectum, might be administered. As 

 the kidneys and skin (to a less degree) are the organs which remove the 

 bile that has been absorbed into the blood, we may with advantage stimu- 

 late them. For this object, I would advise the use of nitre, which acts on 

 the kidneys, or of sweet spirits of nitre, which acts on the kidneys and 

 skin, and is also a stimulant ; warm fomentations over the region of the 

 liver (the right side) ; and warm clothing. To aid in overcoming the great 

 debility, as well as to stimulate the kidneys and skin, the employment of 

 sweet spirits of nitre is specially indicated. Care should be taken to allow 

 the animal a plentiful supply of fresh water, in order to keep the blood 

 in a sufficiently fluid condition. Moderate exercise and a full supply of 

 fresh air are essential. 



While we have thus endeavoured to reduce the congestion of the liver, 

 to remove bile which has been absorbed into the blood, and to overcome the 

 constipation of the bowels, we have in ipecacuanha a, valuable agent for 

 relieving the obstruction to the flow of bile into the intestines ; for restoring 

 the glajid to its healthy function ; for mitigating the congestion ■ and for 

 allaying the fever, by its sedative properties. It appears to act by stimu- 

 lating involuntary muscular fibre, and thus relieves congestion of the blood- 

 vessels of the liver by causing their muscular coats to contract ; and, in the 

 same manner, the obstruction in the bile-ducts is relieved, and the secretion 

 is allowed to flow into the intestine. The action of this drug, here, is very 

 similar to that which it has in relieving the distressing symptoms of 

 bronchitis in the human subject; for when the mucous membrane of the 

 bronchial tubes is dry and inflamed, it alleviates the congestion of the 

 blood-vessels and causes a healthy secretion of mucus ; and if the bronchial 

 tubes are blocked up by mucus (phlegm), it stimulates their muscular coats 

 to expel it. 



Alhalies, such as the bicarbonate of soda, are very useful, for they greatly 

 assist in the oxidation of the products of unused nutritive matter and of 



