CONTENTS.
[Pathological conditions with which jaundice is associated]—Those of the liver itself—Those of the bile-ducts—General affections of other organs of the body exerting an influence on the biliary secretion—Zymotic diseases—The effects of certain poisons
[Frerichs's theory of jaundice]—Theory of jaundice hitherto most favoured in England—Dr. Budd as its exponent
[Nature of bile]—Biliverdine—Bile acids; glycocholic, and taurocholic acids—Cholesterine—Bile resin—Sugar—Inorganic constituents—Specific gravity, reaction, and colour of normal bile
[Manner in which bile is secreted]—Liver both a formative and excretive organ—Animals without gall-bladders—Effects of food on the colour and quantity of the bile
[Is bile essential to life?]—Effect on the system of absence of bile in the digestive process—Death from starvation as a result—Benefit derived from an additional quantity of food—Uses of bile in the animal economy—Necessary to the absorption and assimilation of food—Bile as a digestive agent—Its action on the chyme—Experiments on its influence over the absorption of fatty matter—Its relation to the pancreatic juice—Bile taken internally by Caffres
[General view of the mechanism of jaundice]—Two great divisions—Jaundice from suppression, and jaundice from re-absorption—1st subdivision: jaundice arising from enervation, disordered hepatic circulation, and absence of secreting substance—2nd subdivision: jaundice arising from congenital deficiency of the bile-ducts, and from accidental obstruction of the bile-ducts
[Mechanism of jaundice as a result of enervation]—Influence of nervous system on secretion—Effect of mental emotion on biliary secretion, as observed in dog with biliary fistula—Action of fright in paralyzing nerve force
[Mechanism of jaundice from hepatic congestion]—Active congestion—General view of the effects of congestion on glandular secretion—Reason why the biliary secretion is not usually completely arrested—The absence of pipe-clay stools explained—Example of jaundice from hepatic congestion—Jaundice from zymotic disease, and other cases of blood-poisoning, have a similar mechanism—Example of jaundice following upon ague—Effect on the urine—Analysis of the urine a clue to the nature of the case
[Passive congestion of the liver as a cause of jaundice]—Cases associated with heart disease, pneumonia, &c.—Explanation of the reason why jaundice is so frequently absent in such cases
[Mechanism of jaundice arising from suppression consequent upon absence of the secreting substance]—Cancer, tubercle, &c.—Effects of the position of the morbid deposit in modifying the result
[Jaundice arising from acute, or yellow atrophy of the liver]—State of the urine in such cases—Presence of bile-acids—Pettenkofer's test—Tyrosine and leucine in the urine—An example of the affection occurring in a young woman—Exciting cause—State of the liver tissue—Poisonous effects of glycocholate of soda injected into the circulation
[Mechanism of jaundice arising from the re-absorption of the secreted but retained bile]—Jaundice arising from a congenital deficiency of the ducts—History of a case
[Pathology of jaundice resulting from the accidental obstruction of the bile-ducts]—Mode of formation of gall-stones—Jaundice only present when the stone is lodged in common duct—How gall-stones may imperil life without inducing jaundice—Modes of escape from the gall-bladder—Presence of foreign bodies, such as cherry-stones in gall-duct—Jaundice arising from hydatids impacted in the common duct
[Mechanism of permanent jaundice from obstruction]—Resulting from organic disease—Cancer of head of pancreas—Effect of the dilatation of the bile-ducts in the liver—Effect on the nutrition of the parenchyma of liver—Different stages in size through which the liver passes—Difficulties of diagnosis—Cause often obscure—Key to its detection
[Analysis of the intestinal secretion an aid to the diagnosis of obscure cases of abdominal disease]—Colour, nature, and chemical composition of the stools—Changes produced in them by different foods, and remedies
[Examination of the renal secretion]—Diagnostic value of the colour of the urine—Colour produced by urohæmatin to be distinguished from that produced by biliverdine—Simple method of separating the pigment from the urine—Advantage of at the same time ascertaining the quantity of uric acid present—Effect of the bile pigment becoming deposited in the kidneys—Production of secondary disease
[Diagnostic value of the presence of the bile-acids in the urine]—Views of Frerichs, Städler, and Kühne—Hoppe's method of detecting the bile-acids—Frerichs's theory of the transformation of bile-acids into biliverdine shown to be untenable
[Diagnostic value of the presence of tyrosine, and leucine in the urine]—Microscopic appearances of these substances—Mode of separating them from urine—Chemical tests
[Melanine in the urine in cases of cancer of the liver]—The characters by which it is to be distinguished from bile pigment—Case related showing the value of the test
[Diagnostic value of ascertaining the quantity of urea, and uric acid, as well as the presence of sugar in the urine in obscure cases of jaundice]—History of a case illustrating the value of such knowledge—Significance of the presence of fatty acids in the fæces in the diagnosis of pancreatic disease—Pancreatine administered—Effect of bile-poisoning on the memory—Analysis of the patient's urine—Diagnostic value of the quantity of its constituents pointed out—Appearance of sugar as the forerunner of a fatal termination alluded to—Disappearance of bile-acids, and appearance of tyrosine and leucine in the latter stages of the disease—Post-mortem appearances described—Occlusion of bile, and pancreatic ducts—Analysis of healthy and diseased bile—Change in the proportion of the organic greater than in that of the inorganic constituents—Microscopic appearances of liver—Presence of crystals of cystine, as well as of tyrosine in the hepatic parenchyma
[Jaundice from obstruction in its latter stage complicated with jaundice from suppression]
[Epidemic jaundice]—Among soldiers—Among pregnant women—Among the entire civil population—Its mechanism—Its cause—Case of jaundice supervening upon scarlatina
[Artificial jaundice]—Mode of production—Experiments related—Tyrosine, and leucine supposed to be the result either of the arrested, or of the retrograde metamorphosis of glycocholic, and taurocholic acids—Biliary acids detected in the blood—Poisonous nature of the constituents of the bile—Condition of the blood in bile-poisoning
[Treatment of jaundice]—Totally different in jaundice from suppression and in jaundice from obstruction—Benefit of mercury in cases of jaundice—General theory regarding the action of mercurials—Benefit of acids, and of alkalies—Their mode of action explained—Theory of their action in cases of gall-stones—Lithia water—Treatment of jaundice by benzoic acid—Cases illustrating its mode of action—Podophyllin a bane, and an antidote in cases of jaundice—Its pernicious effects in cases of obstruction pointed out—Author's theory of its action in such cases—Method of detecting gall-stones in the stools—Sulphuric ether, and chloroform in cases of gall-stones—Taraxacum
[Difficulties in the treatment of jaundice from obstruction pointed out]—Derangements arising from absence of bile in the digestive process—Good effects of an additional quantity of food—Establishment of an artificial biliary fistula shown to be less hazardous than usually imagined—Mode of operation explained—Treatment of permanent jaundice by prepared bile—New mode of preparing bile pointed out—Theory of its action—Time of administration shown to be of much importance—Bile put into capsules—Benefits derived from bile given in this form
[Tabular view of the pathology of jaundice according to the author's views]