The skin, eyes and mucous membrane turn yellow, the urine is beer-colored and forms a yellow froth on shaking, the stools are very light in color (clay colored), the patient loses his appetite, is nauseated, weak and suffers with headache and the skin becomes extremely itchy.
What used to be called by the general term "catarrhal jaundice" is now divided into a few varieties which are not yet definitely understood. But we do know that some cases are due to a germ or virus infection, while others are due to a toxic blood poisoning which damages the liver cells, and still another class of cases of jaundice arises from inflammation of the duodenum and bile duct causing an obstruction of the flow of bile, which gets dammed up in the liver thereby causing damage to the liver and absorption of bile into the blood.
Anyway, in jaundice there is always some liver damage and absorption of bile by the blood, which carries it to all body tissues and the skin giving them the yellow color.
During world war II there were recurring epidemics of jaundice among our troops.These epidemics were often caused by or followed vaccinations and blood serum injection. It may have been some sort of contamination of the injected material or just a toxic reaction of the material itself.
Investigation has proved that unsterilized syringes were the cause of these fatal infections in most cases. To much stress was laid on those injections rather than on hygiene and sanitation.
On the other hand, there cannot be much observance of hygiene and sanitation in "fox-holes." But I was told, first hand, that in a naval training station right in the u.s.a. the food was decidedly contaminated by waste and dirt and that meant neglect of duty of some Brass Hat and the undermining of our boys' health before they got to the war front. And for jaundice to follow the consumption of contaminated food is as natural as for night to follow day.
The sanitary preparation and handling of food should be under the strict supervision of the medical corps as is vaccination and serum injection, but there seems to have been neglect even in this last performance as well.
Eating contaminated or spoiled food at home or in a restaurant will cause gastrointestinal upset, irritation and inflammation with obstruction to the bile flow, and even direct injury to the liver by germ and poisonous material from the spoiled and contaminated food.
Injury to the liver and obstruction to the flow of bile can be caused by any infectious disease or by growths, tumors or enlarged glands in any abdominal organ. All these conditions must be excluded before a case of jaundice can be declared to be just a mild infection and catarrhal condition.
It seems that all the complicated liver tests do not amount to very much in the final diagnosis. Even the dangerous biopsy and direct examination of a specimen of liver tissue, which is obtained by inserting a specially constructed needle into the liver, is not of definite diagnostic value.
The pathological appearance of the liver tissue changes many times during the course of liver disease, no matter what cause , and confusion of diagnosis is likely to be the result.
As I have maintained in many parts of this web, the competent general practitioner, the family physician who knows the patient well arrives at a more certain diagnosis by using his practical clinical judgment than by the use of all the doubtful tests. Recent reports in medical literature confirm this assertion.
The treatment of catarrhal jaundice consists of rest in bed for a week or ten days. Give the patient 2 teaspoonfuls of epsom salt in half a glass of water every morning on an empty stomach.
He should then lie on his right side for half an hour and no food be given him for that long or longer. The epsom salt relaxes the bile duct, drains the bile and keeps the bowel clean.
The first three days the diet should consist of skimmed milk diluted with thin, strained brown rice or oatmeal and well sweetened.
Both cereals should be cooked well and long. In addition to that he should have plenty or freshly prepared and strained fruit juice that are well sweetened with dextrose and brown sugar. Orange,grape fruit and lemon juice are best. He may also have grape juice and jello during the 3 days, but no cream,butter or any other fat is allowed.
All fat must be excluded from the diet for a long time. The patient may also have a quart of skimmed milk and the white of an egg a day during the first 3 days.
After the first 3 days he may have well cooked cereals like oatmeal, brown rice and wheatena, whole wheat toast soaked in milk, the whites of 2 eggs, a small portion of lamb or the white meat of chicken or fish. The lamb ,chicken or fish must contain no skin or fat.
Any non-fatty fish is good.He may have un-creamed cottage cheese and also the quart of skimmed milk, jello and fruit juices as on the first 3 days of the diet.
He should also be given the following prescription:
- Sodium salicylate 2 drams
- Rhubarb and soda mixture ( enough to make 4 ounces)
Mix and direct to take a teaspoonful every 3 hours followed by a glass of water.
The following is to be taken for about 2 weeks:
- Vitamin K (Menadione) 0,5 grain
- Dehydrocholic acid 1 dram
Mix and divide into 30 capsules. Take one twice daily, one after lunch and one after dinner
Dried brewers' yeast tablets should be taken, 3 after each meal. Some doctors think that some butter or other fats may be had by jaundice patients, unless it actually disagrees with a particular one.
To my mind, it is the same sort of wisdom as those who advise alcohol in liver disease and other diseases.It is simply a refusal to part with an injurious habit as long as it does not kill outright.
Fat and alcohol are positively injurious to the jaundice patient and alcohol is so anytime to everybody. Jaundice may be caused by drugs, such as arsenic, used in the treatment of syphilis and other diseases.
The sulfa drugs are sometimes the cause of jaundice. So do not be in a hurry to take sulfa for any little sore throat that can be treated with much less poisonous drugs. And do not let yourself be persuaded to take arsenic injections for a light case of anemia.
Arsenic should not be used at all for such conditions by injection or by mouth