92 DISEASES OF THE DIGESTIVE APPARATUS. 



The body of the liver may be changed ; it is generally enlarged 

 and ansemic, and varies in color from a yellow to a yellowish- 

 brown. The color is not regular, but spotted like a nutmeg. The 

 cells of the liver are infiltrated and filled with drops of fat, colored 

 with brownish pigment in the shape of granulated clots. The 

 cadaver is generally ansemic ; the blood is either clotted, and in 

 the heart and large bloodvessels we find large lumps of hard red- 

 dish-yellow coagula, or the blood may be stained yellow and eon- 

 tain white blood-corpuscles in increased quantities. The red 

 blood-corpuscles are not much changed, but vary in size. All the 

 tissues of the body, except the white substance of the brain, the 

 spinal cord, and the corneal tissue, are stained more or less by 

 the bile-pigment. The muscles of the heart undergo a certain 

 amount of fatty degeneration. The kidneys are ansemic ; in the 

 pale portion of the kidney we see extensive whitish stripes run- 

 ning in the direction of the urinary canals ; this is caused by an 

 irregular fatty degeneration and pigmentary infiltration of the 

 canals (Siedamgrotzky). 



Clinical Symptoms and Couese op the Disease. As this 

 disease is generally associated with catarrh of the stomach, the 

 first symptoms in jaundice will be of that disease — loss of appetite, 

 vomiting, coated tongue ; in some rare instances, however, these 

 may be absent. The first symptom being that of jaundice (yel- 

 lowness of the mucous membranes), when the bile and bile acids 

 enter the blood the following symptoms are observed : 



1. By the entrance of the coloring-matter of the bile into the 

 tissues these become more or less yellow, the first being the yel- 

 lowness of the conjunctiva and the sclerotic coat; later the whole 

 cutaneous covering becomes tinted. The yellowness may be very 

 plainly seen on the abdomen, on the inner fascia of the thighs, and 

 the mucous membranes of the mouth and throat ; the color may 

 raiige from a light yellow to a dirty orange-yellow ; the latter color 

 generally spreads over the entire body in the later stages of the 

 disease. 



2. On account of the coloring-matter being present in the urine 

 it is changed from the normal to a yellowish-green or to a dark 

 greenish-brown color ; when put in a vessel and agitated it foams 

 very easily; and if a piece of paper or linen is placed in it, it 

 becomes tinted the color of bile. It is also easy to detect the 



