Page:Encyclopædia Britannica, Ninth Edition, v. 13.djvu/627

j A U J A U 599 bile acids. The former is detected by the play of colours yielded on the addition of nitric acid, the latter by the purple colour produced by placing a piece of lump sugar in the urine tested, and adding thereto a few drops of strong sulphuric acid. This test for the bile acids is dwelt upon by Dr George Harley as an important point in serving to distinguish jaundice with obstruction from jaundice without obstruction, in the latter of which, although there is bile pigment in the urine, the bile acids are absent. The contents of the bowels also undergo changes, being characterized chiefly by their pale clay colour, which is in proportion to the amount of hepatic obstruction, and to their consequent want of admixture with bile. For the same reason they contain a large amount of unabsorbed fatty matter, and have an extremely offensive odour. Constitutional symptoms always attend jaundice with obstruction. The patient becomes languid, drowsy, and irritable, and has generally a slow pulse. The appetite is usually but not always diminished, a bitter taste in the mouth is complained of, while flatulent eructations arise from the stomach. Intolerable itching of the skin is a common accompaniment of jaundice, and cutaneous erup tions or boils are occasionally seen. Yellow vision appears to be present in some very rare cases. Should the jaundice depend on advancing organic disease of the liver, such as cancer, the tinge becomes gradually deeper, and the emaciation and debility more marked towards the fatal ter mination, which in such cases is seldom long postponed. Apart from this, however, jaundice from obstruction may exist for many years, as in those instances where the walls of the bile ducts are thickened from chronic catarrh, but where they are only partially occluded. In the common cases of acute catarrhal jaundice recovery usually takes place in two or three weeks. The treatment of this form of jaundice bears reference to the cause giving rise to the obstruction. In the ordinary cases of simple catarrhal jaundice, or that following the passing of gall stones, a light nutritious diet (milk, soups, &c., avoiding saccharine and farinaceous substances and alcoholic stimulants), along with counter-irritation applied over the right side, and after a few days the use of laxa tives which tend to promote the flow of bile, will be found to be advantageous. Rhubarb, taraxacum, podophyllum, mercury, are among the remedies which have long been employed for this purpose, but the recent researches of Professor Rutherford have brought to light certain other agents (euonymin, iridin, leptandrin, &c.), which exercise a powerful influence as cholagogues, and are now coming into use. Diaphoretics and diuretics to promote the action of the skin and kidneys are useful in jaundice. In the more chronic forms, besides the remedies above named, the waters of Carlsbad are of special efficacy. Where the jaundice depends on changes in the substance of the liver, altering its structure, such as cancerous deposit, all that can be accomplished is the palliation of symptoms, includ ing the jaundice, which may be mitigated by the treatment already indicated. With the view of supplying bile to the alimentary canal, Dr Harley recommends the use of inspis sated ox-gall in doses of 5 to 10 grains administered in capsules of gelatin. 2. Jaundice ivithout obstruction is observed to occur as a symptom in certain fevers, e.g., yellow fever, ague, and relapsing fever, and in pyaemia (blood poisoning), also as the effect of the action of certain poisonous substances, such as copper, mercury, antimony, phosphorus, &c., and the venom of snake bites. It is occasionally seen in new-born infants. It is sometimes suddenly induced as the result of strong mental excitement or emotion. Much difficulty has always been felt to account for this form of jaundice, and numerous theories have been advanced to explain its occurrence. Many of such cases might probably, as Virchow observes, be found on careful investigation to depend on some obstruction in the biliary passages ; but there can be no doubt that many others admit of no such explanation, and as regards these it is generally held that they are probably connected with some alteration in the colouring matter of the blood, the source, it is believed, of the bile pigment. Others suppose this form of jaundice to be due to an excess in the normal reabsorption of bile into the blood. The pathology, however, is still unsettled. Jaundice of this kind is almost always slight, and neither the urine nor the discharges from the bowels exhibit changes in appearance to such a degree as in the obstruc tive variety. Grave constitutional symptoms are often present, but they are less to be ascribed to the jaundice than to the disease with which it is associated. The name malignant jaundice is sometimes applied to that very fatal form of disease otherwise termed acute yellow atrophy of the liver. See ATROPHY. (j. o. A.) JAUNPUR, a British district in the lieutenant- governorship of the North-Western Provinces, India, lying between 25 23 15" and 26 12 N. lat., and between 82 10 and 83 7 45" E. long. It forms the north-eastern district of the Allahdbad division, and is bounded on the N. and N.W. by the Oudh districts of Faizabad, Partabgarh, and Sultanpur, on the E. and N.E. by Ghazipur and Azamgarh, on the S. by Benares and Mirzapur, and on the W. by Allahabad. The district of Jaunpur forms part of the wide Gangetic plain, and its surface is accordingly composed of a thick alluvial deposit. The whole country is closely tilled, and no waste lands break the continuous prospect of cultivated fields. The northern and central positions are richly wooded. The district is divided into two unequal parts by the sinuous channel of the Gumti, a tributary of the Ganges, which flows past the city of Jaunpur. Its total course within the district is about 90 miles, and it is no where fordable. It is crossed by two famous bridges, one at Jaunpur and the other 2 miles lower down. The other rivers are the Sai, Barna, Pilli, and Basohi. Lakes are numerous in the north and south ; the largest has a length of 8 miles. The census of 1872 was taken upon an area of 1556 square miles, and it disclosed a total population of 1,025,961, of whom 545,752 were males and 480,209 females. Jaunpur is essentially a Hindu district, in spite of its long subjection to Mahometan rulers. The returns show 929,525 Hindus to 96,319 Mahometans; the Christian population (European and native) numbers 117. There are only two towns with more than 5000 inhabitants, Jaunpur, 23,327, and Machhlishahr, 8715. The ordinary soil of Jaunpur is a mixture of mould, clay, and sand ; but in old river beds and the basins of temporary lakes a rich black alluvial deposit may occnsionally be found. The harvests are those common to the rest of Upper India. The crops yielded are cotton, rice, btijra,jodr, moth, wheat, barley, oats, pease, and other pulses. Sugar yields the greatest profit, but it requires great care. Indigo, poppy, tobacco, and vegetables are also cultivated. The Gumti is liable to sudden inundations during the rainy season, owing to the high banks it has piled up at its entrance into the Ganges, which act as dams to prevent the prompt outflow of its flooded waters. These inundations extend to its tributary the Sai. Much damage was thus effected in 1774 ; but the greatest recorded flood took place in September 1871, when 4000 houses in the city were swept away, besides 9000 more in villages along its banks. On the other hand, Jaunpur has been comparatively free from drought, the great plague of the north-west generally, as of the rest_ of India. The district is almost entirely devoted to agriculture, and its trade is confined to raw materials and food-stuffs. The principal fairs are held at Mariahu in September, and at Karchuli in March ; they are attended by from 20,000 to 25,000 pilgrims and traders. The Oudh and Rohilkhand railway passes through the district. There are 145 miles of metalled and 364 of unmetalled roads. The Gumti and Sai are navigable for boats of moderate burden. The climate is moist, and the temperature is more equable, and the rain more evenly distributed throughout the year, than in most districts of tin: North-Western Provinces, the average rainfall for 1861-70 was