Jaundice: Its Pathology and Treatment: With the Application of Physiological Chemistry to the Detection and Treatment of Diseases of the Liver and Pancreas — John Shaqi
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
Secondly, IN DISEASES OF THE BILE-DUCTS--
_(a)_ Congenital deficiency.
_(b)_ Accidental obstruction. The latter arising from gall-stones,
hydatids, foreign bodies {4} (such as cherry-stones and
entozoa) entering from the intestines.
_(c)_ Ulcer of the duodenum.
_(d)_ Tumours of the pancreas.
Thirdly, IN AFFECTIONS OF OTHER ORGANS OF THE BODY EXERTING AN
INFLUENCE ON THE BILIARY SECRETION--
_(a)_ Diseases of the nervous system.
_(b)_ Diseases of the lungs.
_(c)_ Diseases of the heart.
_(d)_ Imperfect establishment of the extra-uterine circulation
(infantile jaundice).
_(e)_ Dyspepsia.
_(f)_ Torpidity of the bowels, and consequent accumulation of fæces
in transverse colon.
_(g)_ Pregnancy.
Fourthly, IN A VARIETY OF ZYMOTIC DISEASES--
_(a)_ Typhus.
_(b)_ Yellow fever.
_(c)_ Ague.
_(d)_ Pyæmia.
_(e)_ Epidemic jaundice.
Fifthly, AS A RESULT OF THE INJURIOUS EFFECTS OF CERTAIN POISONS--
_(a)_ Snake bites. {5}
_(b)_ Alcohol.
_(c)_ Chloroform, etc.
Can it be wondered, then, that a state so easily diagnosed is
nevertheless so difficult to comprehend?
Notwithstanding the apparent incongruity of the diseases with which the
one common symptom of jaundice is associated, I trust to be able to
reconcile these discrepancies, and prove that the seeming discord is
but "harmony not understood."
All physicians, I think, admit that the peculiar state of the system to
which the name of jaundice has been applied, is essentially due to some
derangement of the biliary function, the exact nature of the
derangement being alone the point of contention. I need not, therefore,
waste the time of my readers, either by giving an account of the
literature or a detail of the symptoms of jaundice. Even in discussing
its pathology, I shall strictly limit myself to the consideration of
the opinions at present held by the more advanced of our pathologists;
the object of this monograph being, not to pourtray the views of
others, but to give a brief _exposé_ of my own, and to point out how
modern physiology, and chemistry have not only thrown a new light on
its pathology, but have also given us a clue to its successful
treatment.
{6} Frerichs, the most recent writer on this subject, in his elaborate
treatise on diseases of the liver, says that jaundice may result from
one of the three following conditions:--
Firstly,--Obstruction to the escape of bile.
Secondly,--Diminished circulation of blood in the liver, and consequent
abnormal diffusion; both of these conditions giving rise to an
increased imbibition of bile into the blood, and in both cases the
liver being more or less directly implicated.
Thirdly,--Obstructed metamorphosis, or a diminished consumption of bile
in the blood.[1]
[Footnote 1: Frerichs' "Clinical Treatises on Diseases of the Liver."
New Sydenham Society's Translation, vol. i. p. 93.]
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