If this view of the physiology of the biliary secretion be correct, it is perfectly evident that when the secretion of bile is arrested, those substances which the liver generates will be entirely wanting, while those which it merely excretes from the blood will accumulate there as soon as their excretion is prevented; just as urea accumulates in the circulation when its elimination by the kidneys is stopped. Hence it is that, as soon as the biliary secretion is in abeyance, biliverdine accumulates in the blood (until the serum is as it were completely saturated with the pigment), from which it exudes and stains the tissues, and produces the colour we term jaundice. At the same time, or even before the skin becomes yellow, the urine assumes a saffron tint in consequence of the elimination of the colouring matter by the kidneys.[8] From this it will be seen that I regard {22} the yellow skin and high-coloured urine of jaundice as simply due to the deranged secretion of biliverdine, quite independent of the presence or absence of the other constituents of the bile, the effects produced by which will be referred to elsewhere. Meanwhile we shall separately consider the further pathology of the three subdivisions of jaundice arising from suppression. [Footnote 8: The true order of the occurrence of these changes is:--On the second day the urine becomes high-coloured; in a day or two later the skin assumes a yellow tint; and, in very severe cases, within the first week or two, the sweat, the milk, the tears, the sputa, and the serum in the thoracic and abdominal cavities, become of a more or less decided yellow hue.] JAUNDICE AS A RESULT OF ENERVATION.