Part 78

A. Jaundice From Mechanical Obstruction of the Bile Duct.

I. Obstruction by foreign bodies within the duct:

1. Gall stones and inspissated bile.

2. Hydatids and distomata.

3. Foreign bodies from the intestines.

II. Obstruction by inflammatory tumefaction of the duodenum or of the lining membrane of the bile duct with exudation into its interior.

III. Obstruction by stricture or obliteration of the duct.

1. Congenital deficiency of the duct.

2. Stricture from perihepatitis.

3. Closure of the orifice of the duct in consequence of ulcer of the duodenum.

4. Stricture from cicatrization of ulcers in the bile duct.

5. Spasmodic stricture.

IV. Obstruction by tumors closing the orifice of the duct or growing in its interior.

V. Obstruction by pressure on the duct from within, by:

1. Tumors projecting from the liver itself.

2. Enlarged glands in the fissure of the liver.

3. Tumor of the stomach.

4. Tumor of the pancreas.

5. Tumor of the kidney.

6. Post peritoneal or omental tumor.

7. An abdominal aneurism.

8. Accumulation of fæces in the bowels.

9. A pregnant uterus.

10. Ovarian and uterine tumors.

B. Jaundice Independent of Mechanical Obstruction of the Bile Ducts.

I. Poisons in the blood interfering with the normal metamorphosis of bile.

1. The poisons of the various specific fevers (Anthrax, Texas fever, Hog cholera, Swineplague, Petechial fever, Pyæmia, Septicæmia, etc.).

2. Animal poisons: snake poison.