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August 15, 1908


JAMA. 1908;LI(7):606. doi:10.1001/jama.1908.02540070064006

The pathogenesis of icterus has been a continually debated subject, and although there is now general acceptance of the view that in nearly all, and perhaps in all cases, there is some form of obstruction to the escape of bile, yet the mechanism and cause of the obstruction are not always clear. If the icterus is transient and not accompanied by severe constitutional symptoms the usual assumption is that an inflammatory process in the duodenum has extended into the ampulla of Vater, which becomes closed either by the swelling of the mucosa or by a plug of thick mucus, hence the term "catarrhal jaundice." The general acceptance of this view is probably due to the observation by Virchow in a case of this kind that came to autopsy, in which it was found that a duodenal inflammation had extended along the bile ducts to the liver, and had resulted in