Causes.—­This occurs mostly in young people.  It follows inflammation of the stomach or bowels, also from emotion, exposure, chronic heart disease.  It may be epidemic.

[Digestive organs 129]

Symptoms.—­Slight jaundice preceded by stomach and bowel trouble.  Epidemic cases may begin with chill, headache and vomiting.  There may be slight pain in the abdomen, the skin is light or bright yellow, whites of the eyes are yellowish, pain in the back and legs, tired feeling, nausea, clay colored stools.  Pulse is rather slow, liver may be a little enlarged.  It may last from one week to one to three months.

Physicians’ treatment for Catarrhal Jaundice.—­1.  Restrict the diet if the stomach and bowels are diseased.  Sodium phosphate may be given one teaspoonful every three hours to keep the bowels open.  Drink large quantities of water and with it some baking soda one-half to one teaspoonful in the water.

2.  If you have calomel you may take one-tenth of a grain every hour for four hours, and then follow with the sodium phosphate in one-half teaspoonful doses every two to three hours, until the bowels have fully moved, or epsom salts, two to four teaspoonfuls.  Keep in bed if there is a fever or a very slow pulse say of forty to fifty.

Gall stones. (Biliary Calculi, Cholelithiasis).—­Cases of gall stones are rare under the age of twenty-five years.  They are very common after forty-five, and three-fourths of the cases occur in women.  Many people never know they have them.  Sedentary habits of life, excessive eating and constipation tend to cause them.  They may number a few, several, or a thousand, or only one.

Symptoms.—­There are usually none while the stones are in the gall bladder, but when they pass from the gall bladder down through the (channel) duct into the bowel they often cause terrific pain, especially when the stone is large.  Chill, fever, profuse sweating and vomiting, which comes in paroxysms or is continuous.  The pain may be constant or only come on at intervals.  The region of the liver may be tender, the gall bladder may be enlarged, especially in chronic cases and very tender.  In some cases the pain comes every few weeks and then may be scattered, sometimes seeming to be in the stomach, and then in the bowels, or in the region of the liver.  When a person has such pains and locates them in the stomach or bowels, and they come periodically, every week or two or more, he ought to be suspicious about it being gall stones, especially if the symptoms do not show any stomach trouble.  If the stone is large and closes the common duct, jaundice occurs; the stools are light colored; the urine contains bile.  The attacks of pain may cease suddenly after a few hours, or they may last several days or recur at intervals until the stone is passed.  The stones may be found in the bowel discharges after an attack.  Death may occur from collapse during an attack.