CaSC of primary icterus gravis observed in which the temperature always ranged below the normal. Death followed. Cul tivations made with the blood and liver remained sterile and no micro-organism was demonstrated on staining the sec tions of that organ. J. Durante (Bull. de la Soc. Anat., No. 24, '94).
Four cases of icterus gravis in which the results of bacteriological examination led the writer to conclude that they could be regarded as variable stages of the same form of septicfernia caused by streptococci. Babes (Revue des Sci. Med. en France et l'Etranger, July 15, '94).
Three cases of icterus coming on at an early- period of syphilis noted. Table of forty-six additional cases added with a view of establishing the differential diag nosis between simple catarrhal and syphi litic ieterus. The latter usually comes on suddenly, without being preceded by the digestive disturbances which are the prelude of the catarrhal form; in some eases the digestion remains excellent throughout, though, as in catarrhal jaun dice, there is a distaste for fats. An other point to be noted is the absence of any etiological factor except syphilis. The jaundice usually appears with the first eruption, and is most frequent in females. O. Lasch (Berliner klin. Woch., Oct. 1, '94).
Observations based on 57 cases of jaun dice occurring among 15,799 cases of early syphilis. Syphilitic jaundice is characterized by (I) its appearance in the early secondary stage, (2) the pres ence of fresh specific manifestations, (3) the influence of treatment, and (4) its sudden development without gastric dis turbance. Long duration is not char acteristic of syphilitic jaundice. In typ ical cases this ieterus occurs at a time when syphilis affects the skin and mu cous membranes. Hepatic enlargement is not a striking feature in the disease. In 22 out of 50 eases the jaundice was noted within six months after the infec tion. The syphilis in most of the cases was severe. In 50 cases cutancons affec tions were present in 18, affections of the mucous membranes in 16. Marked gland ular enlargement \vas present in 41 out of 50 eases. Werner (111finch. med. Woch., July C, '97).
Jaiindice is a somewhat rare complica tion of pregnancy, Karl Bram), having observed the grave form only once in 28,000 preg,nant women, and Wir.ckel
only once in 16,000 cases. William Young (Med. News, Nov. 12, '98).
Icterns observed in four cases from the use of lacloplienin. Kurt Witthailer (Ther. Mounts., H. 2, S. 111, '98).
variei ics jdundiec are found in infancy. There i•; benign icterus neonatortun, liwnifttogenniis elmrac t. tt the 1.(1111 lic e be .opt 1Ze 0.1,1 to Hu. 1, that rare comfit ion called k .11sca,-e. l'bcn there arc NVinck tr, di-case atobritc. icterit. cyanosis \tub eti•ily recognized ti on it- 'opt inieet ion!, jaumlive t I he Ilevd,0121. ,t art from he ..2-as I M1,0,1141,11 IV.It : 1.10: V11E011111' j:11111- ol, o, follow ing 11.etnorrlinge: entarrlittl imindi,e; o‘ie jaundice; joundiee with nte t liver: and eon -016(.11 It tern,. dtle to defeet or °Niter t),11 01 the bile-duets. eirrilo:.is of t he nn,1 or in the bcpatio or portal 13. Skormitt Jahrbttch f. Aug.. 190:21.
In :.-onie cases, as in pyrumia and snake venom, the poison finds its way to the liver through the general circulation.
Icterus Neonatorurn.
Definition.—Icterus neonatornin is a mild transitory form of jaundice of un certain causation appearing in infants soon after birth. There is also a severe form of jaundice caused by congenital absence or occlusion of the hepatic duct, or due to septic infections. especially pvlephlebitis. As this form does not arise from the same condition in the adult. it is wiser to confine the true "icterus neonatorum" to the first form.
Symptoms.—The icteric tinge is gener ally the only symptom. the child other wise being well. lt occurs in delicate children oftener than in the strong. It s.een more frequently in hospitals than in private practice. perhaps because the light is better in the hospitals and records are more carefully made. It is of fre quent occurrence, being noted in as many as SO or even 90 per cent. in some reports. It is probable that careful examination nf all infants will reveal this large ratio. Wl.en very slight it may be best detected on the red skin rendered pallid by press ure. It usually appears on the second or third day, increases for a day or two and ing from four to five days to a week, last ing a fortnight in severe cases only.