CHAP. XXXVI.
OF THE JAUNDICE.
This disease is first observable in the white of the eye, which appears yellow. Afterwards the whole skin puts on a yellow appearance. The urine too is of a saffron hue, and dies a white cloth of the same colour. There is likewise a species of this disease called the Black Jaundice.
CAUSES.——The immediate cause of the jaundice is an obstruction of the bile. The remote or occasional causes are, the bites of poisonous animals, as the viper, mad dog, &c. the bilious or hysteric colic; violent passions, as grief, anger, &c. Strong purges or vomits will likewise occasion the jaundice. Sometimes it proceeds from obstinate agues, or from that disease being prematurely stopped by astringent medicines. In infants it is often occasioned by the meconium not being sufficiently purged off. Pregnant women are very subject to it. It is likewise a symptom in several kinds of fever. Catching cold, or the stoppage of customary evacuations, as the menses, the bleeding piles, issues, &c. will occasion the jaundice.
SYMPTOMS.——The patient at first complains of excessive weariness, and has great aversion to every kind of motion. His skin is dry, and he generally feels a kind of itching or pricking pain over the whole body. The stools are of a whitish or clay colour, and the urine, as was observed above, is yellow. The breathing is difficult, and the patient complains of an unusual load or oppression on his breast. There is a heat in the nostrils, a bitter taste in the mouth, loathing of food, sickness at the stomach, vomiting, flatulency, and other symptoms of indigestion.
If the patient be young, and the disease complicated with no other malady, it is seldom dangerous; but in old people, where it continues long, returns frequently, or is complicated with the dropsy or hypochondriac symptoms, it generally proves fatal. The black jaundice is more dangerous than the yellow.
REGIMEN.——The diet should be cool, light, and diluting, consisting chiefly of ripe fruits and mild vegetables; as apples boiled or roasted, stewed prunes, preserved plums, boiled spinage, &c. Veal or chicken-broth, with light bread, are likewise very proper. Many have been cured by living almost wholly for some days on raw eggs. The drink should be butter-milk, whey sweetened with honey, or decoctions of cool opening vegetables; or marsh-mallow roots, with liquorice, &c.
The patient should take as much exercise as he can bear, either on horseback, or in a carriage; walking, running, and even jumping, are likewise proper, provided he can bear them without pain, and there be no symptoms of inflammation. Patients have been often cured of this disease by a long journey, after medicines had proved ineffectual.
Amusements are likewise of great use in the jaundice. The disease is often occasioned by a sedentary life, joined to a dull melancholy disposition. Whatever therefore tends to promote the circulation, and to cheer the spirits, must have a good effect; as dancing, laughing, singing, &c.
MEDICINE.——If the patient be young, of a full sanguine habit, and complains of pain in the right side about the region of the liver, bleeding will be necessary. After this a vomit must be administered, and if the disease proves obstinate, it may be repeated once or twice. No medicines are more beneficial in the jaundice than vomits, especially where it is not attended with inflammation. Half a drachm of ipecacuanha in powder will be a sufficient dose for an adult. It may be wrought off with weak camomile-tea, or lukewarm water. The body must likewise be kept open by taking a sufficient quantity of Castile soap, or the pills for the jaundice recommended in the Appendix.
Fomenting the parts about the region of the stomach and liver, and rubbing them with a warm hand or flesh-brush, are likewise beneficial; but it is still more so for the patient to sit in a bath of warm water up to the breast. He ought to do this frequently, and should continue in it as long as his strength will permit.