Note 93 — OF THE JAUNDICE.

Vomits are reckoned amongst the most efficacious Remedies in this Disorder, and I have often seen good Effects follow their Use.—Janet Crags, a Woman thirty Years of Age, was, on the 21st of December 1758 admitted into St. George’s Hospital for a Jaundice of some Months Continuance. Her Eyes and Skin were not of the common icteric Colour, but of a dark livid yellow, for which Reason both she and the Nurses termed her Disorder the Black Jaundice. She at first complained of a Difficulty of Breathing, and a Weight and Oppression about the Region of the Liver, for which she was blooded, took some Doses of Physick, and the Soap Pills with Rhubarb; but these produced no Change in her Complaints. On the 29th she had a Cough, and complained much of Sickness and Difficulty of Breathing, for which she was ordered a Vomit, and afterwards to take the Squill Draught Morning and Evening, which occasioned a Purging and Gripes. On the 5th of January 1759, the Looseness still continuing, I ordered her to leave off the Use of the Squill Draughts, and to take only some Rhubarb in an oily Draught every Night at Bed-Time. On the 8th, tho’ the Purging had increased, I did not chuse to check it, as I suspected it would prove a Crisis to the Disorder, and therefore only ordered her the Cordial Draughts and Wine to support her Strength. The Looseness continued till the 15th, when most of the icteric Symptoms were gone, and by the 30th they entirely disappeared. However, she continued low, and subject to Flatulencies for some Months afterwards, which were at last removed by the continued Use of Cordials, gentle Bitters, a nourishing Diet, and repeated Doses of Rhubarb; and on the 2d of May she was discharged in a firm State of Health.

Dr. Coe says, “I have more Reason to be satisfied of the Effect of Vomits in dislodging these Calculi, than of any other, or indeed of all other Medicines.” Treatise on biliary Concretions, chap. ii. p. 253. Besides viscid Humours, which Vomits bring away from the biliary Passages, how often are Gall Stones likewise found in the Stools after the Operation of a Vomit? Ibid. p. 256.