Jaundice: Its Pathology and Treatment: With the Application of Physiological Chemistry to the Detection and Treatment of Diseases of the Liver and PancreasHarley, George
Science
Jaundice: Its Pathology and Treatment: With the Application of Physiological Chemistry to the Detection and Treatment of Diseases of the Liver and Pancreas
Harley, George
Jaundice
It is now a well-established fact that all secretions are under the
direct influence of the nervous system. Stimulate a nerve supplying a
gland, and secretion is accelerated; stop the nervous action, and
secretion is as instantaneously arrested. Again, just in the same way
as volition can produce or suspend muscular movement, mental influence
can hasten or retard glandular secretion. As an illustration of this
fact, I need only call to mind the influence the mere sight of food has
in exciting the salivary secretion, and the effect of bad news in
arresting it. Exactly the same influence as is here alluded to, is
exerted by the mind over the biliary function. If, for example, {23} as
Bernard first observed, a dog with a biliary fistula be caressed, the
secretion of bile is actively continued; if, on the other hand, the
animal be suddenly ill-used, the secretion of bile is instantly
arrested. If he be again caressed, the secretion is re-established, and
the bile flows drop by drop from the end of the cannula. Here the
influence is entirely produced through the intervention of the nervous
system; and if such effects as are above described occur in the dog, we
can surely have little difficulty in understanding how the biliary
secretion can be influenced in the highly-developed organization of the
human being. Indeed, every one must have felt how quickly sad tidings
received during a meal not only destroy the appetite and retard
digestion, but occasionally alter the complexion. This effect, that all
of us must have experienced in a slight degree in our own persons,
several may have observed to a greater extent in the persons of others,
even to the production of well-marked jaundice. At this very time I
have under my care a young married lady, who during the last two years
has twice suffered from an attack of jaundice induced by witnessing her
child in convulsions, and this I regard as an example of jaundice from
enervation.
One of the reasons, no doubt, why jaundice does not more frequently
follow upon mental emotion is {24} simply on account of a certain
amount of pigment being required in order to produce a visible tinging
of the body, and it seldom happens that the emotional effect on the
biliary secretion is sufficiently permanent to permit of the requisite
amount of pigment accumulating in the blood. The reason, too, why
mental emotion is more apt to cause jaundice immediately after a meal
is, as will afterwards be better understood, on account of the
congested state of the liver at that time favouring the stoppage of the
secretion. A blow on the head, which is now and then observed to be
suddenly followed by jaundice, acts, I believe, in the same way as
fright, namely, by paralyzing the nerve force required for the
continuance of the biliary secretion.
I now pass on to the consideration of the pathology of the second kind
of jaundice from suppression, namely, jaundice resulting from hepatic
congestion.
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