Biliousness is a favourite complaint. Many people, whenever they are troubled with head ache, sickness, or vomiting, attribute their illness to "au attack of the bile." A man drinks too freely some evening, and rises with a severe headache next morning, or perhaps doesn't rise next morning because of a severe head ache. He tells his friends, his business asso ciates, or his employer that he had a "bilious headache." Many who do not know what it is to practise self-restraint in eating, drinking, or in any other direction, are loud in their complaint of "the bile," that baneful juice that deprives them of all pleasure in life. Biliousness is thus not only a favourite, but also a convenient complaint.
Now it may be that sometimes an excessive amount of bile is poured out of the hepatic duct, which, as we have seen (p. 201), opens into the small intestine a few inches below the stomach. In such a case some of the bile may readily find its way up into the stomach, pro voke vomiting, and lead to loss of appetite for a time, because the stomach is unaccustomed to its presence. This is, perhaps, not unlikely to happen after a long fast, during which bile has been formed by the liver and has not been required. The accumulated bile may, there fore, for little reason, discharge itself into the intestine, and, meeting with no food to use it, may give rise to so-called bilious symptoms. It may, however, be set down as a rule that this is not a common occurrence. In short, bilious ness is simply a common term employed for various and different affections, most of which we have already considered. Thus nausea and sickness, with loss of appetite, a dull headache, and perhaps a slightly yellow tinge of the whites of the eyes, are symptoms akin to those described under CONGESTION OF THE LIVER, and are to be treated as there advised.
The symptoms may also be due to chronic biliary catarrh (p. 272), or to gall-stones (p. 274).
Again, many people, specially women, are troubled with regularly recurring attacks of severe headache, with intense sickness and vomiting. The vomit is at first of the contents of the stomach, but is soon tinged with bile, and the attack is at once ascribed to bile, After some hours' or a day's suffering the head. ache and sickness gradually subside under the influence of quiet rest in bed in a darkened room. Now this is not biliousness. It is
Probably an attack of what has been described on page 169 as sick headache, or megrim, oz brow-ague, and is to be treated as thererecom• mended. The presence of bile in this case is easily accounted for. It only appears after vomiting has occurred once or twice. The pressure exerted on the gall - bladder by the efforts of retching forces the bile into the small intestine and up into the stomach, from which it passes with the vomit. It is not the presence of bile that causes the vomiting; it is the con tinuance of the vomiting that causes the pres ence of bile in the stomach.
There are many vague symptoms which people ascribe to biliousness : bad appetite, bad taste in the mouth, irregular or costive bowels, a tendency to dull headache, which may be the symptoms of slow digestion. A saline purgative in early morning, and in general the treatment advocated for indigestion will probably relieve this condition. The meals should be reduced in quantity ; fats, starchy foods like potatoes, arrow-root; rice, sugar and sweets, should be avoided. Meat should be taken sparingly, and vegetables and fruits freely. Between meals a full interval should occur, 4i to 5 hours, and a tumbler of hot water, with a quarter tea-spoonful of bicarbonate of soda should be taken an hour before each of three meals. Exercise should be freely engaged in.
To repeat, biliousness is a popular name for a great variety of complaints. By carefully ex amining the symptoms in the light of what has been here stated one may arrive at an idea of the probable cause of the trouble, and be able to better the condition.
Jaundice (Icterug) is probably derived from the French jaune, yellow, because of the yellow ness of the skin, characteristic of the disease. It is caused by such obstruction as has been already noted, or by a tumour, cancer for ex ample, pressing on and closing the ducts, or by such diseases of the liver as congestion. In these cases the liver forms the bile, which, however, is not permitted to escape into the bowel. In other cases jaundice occurs during the course of some other disorder, such as yellow fever, relapsing fever, and some forms of blood poison ing. It appears that powerful mental emotion may produce it, probably because of spasmodic closure of the bile-ducts.