On closer study of the various types of jaundice, it is readily realized that, except for jaundice due to mechanical obstruction and for hemolytic jaundice, both of which are well defined by their clinical and anatomic features, there is great incertitude regarding the pathogenesis of the other types of jaundice.
This last type of jaundice is supposed to be due to hepatitis, according to Fiessinger's and Eppinger's investigations. No decisive proof has been produced so far to support such a view. It may be objected that the anatomic evidence, in particular, is not conclusive. Eppinger himself gave a reserved opinion regarding the significance of hepatic lesions in relation to jaundice. More recently several authors insisted on the importance of functional tests. If jaundice is due to hepatitis, on functional investigation the liver must show variations as compared with the normal liver. Later the functional examination of the liver was adopted
PAVEL I. JAUNDICE CAUSED BY FUNCTIONAL OBSTRUCTION: REFLEX SPASM OF THE SPHINCTER OF ODDI. JAMA. 1938;110(8):566–569. doi:10.1001/jama.1938.02790080024007
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