_(b)_ Transverse section of the left lobe, showing the mouths of the enormously distended gall-ducts.
_(e)_ Distended hepatic, and common duct.
_(f)_ Ulceration in duodenum, in the situation of the opening of the gall-duct into the intestines.
_(g)_ Pancreas with enlarged head _(h)_, and enormously distended duct.
External surface of the left kidney, denuded of its capsule, in a case of permanent jaundice.
_(a)_ Small specks of bile pigment deposited in the renal tissue, and blocking up the urine tubes.
_(b)_ Small abscesses scattered throughout the tissue of the kidney.
Fig. 1. Crystals of glycocholate of soda, mag. 90 diam.--Page 8.
" 2. Taurocholate of soda, as found in the form of globules of various sizes.--Page 9.
" 4. Crystals of pure tyrosine.--Page 63.
" 5. Spiculated balls of tyrosine, from the urine of a case of acute atrophy of the liver.--Page 64.
" 8. _(a)_ Crystals of cystine. _(b)_ Hepatic cells, showing entire absence of fat globules. _(c)_ Caudate or spindle-shaped cells, from epithelial lining of hepatic ducts.--Page 86.
Having entitled this monograph "Jaundice, its Pathology and Treatment," it may, perhaps, be necessary for me to state at the beginning that by so doing it is not to be supposed that I regard jaundice as a disease _per se_. On the contrary, I look upon it in the same light as I do albuminuria, which is not of itself a disease, but only the most prominent symptom of several widely-differing pathological conditions. So also the peculiar state of body characterised by yellow skin, saffron-coloured urine, and pipe-clay stools, is itself but a symptom of morbid action. It may be asked, "Then why do you treat of jaundice as if it were a disease?" To this I reply, "Because, although { 2} the condition called jaundice be merely a manifestation of morbid action, and one, too, requiring neither skill nor experience to detect, the proper comprehension of its true mechanism is of much practical importance to the physician, for without this knowledge it is impossible for him to treat it with any chance of success. Nay, even the remedies for jaundice become dangerous weapons, if unskilfully applied." In fact, it is almost unnecessary to apologise for treating of jaundice as a disease _per se_; for, notwithstanding all that has been written upon the subject, it is universally admitted that the simplicity of its diagnosis is only equalled by the obscurity of its pathology, and the uncertainty of its treatment; and no one at all conversant with the literature of jaundice can be in the least degree surprised at this statement. On the contrary, on glancing at the immense variety of morbid states, and known pathological conditions with which it is associated, he cannot fail to admit its truth.