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April 5, 1902


JAMA. 1902;XXXVIII(14):877-878. doi:10.1001/jama.1902.02480140023005

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In not a few cases, the diagnosis catarrhal jaundice, though seemingly forced upon the practitioner by the absence of any other condition to account for the absorption of bile, is eminently unsatisfactory. Not infrequently there have been no symptoms of a preceding catarrhal process in the intestines and no preliminary disturbance of gastro-intestinal digestion. In recent years French clinicians particularly have called attention to the not uncommon occurrence of jaundice after severe emotional strains—the icterus ex emotione of the older medical writers. It is a well-recognized fact that in women particularly an emotional storm may be followed by slight jaundice. Neurotic individuals are prone to have slight amounts of icterus noticeable, especially in the conjunctiva, that are sometimes set down to blood hemolysis, under nervous strain. It would be more satisfactorily explained as due to nervous disturbance of the biliary mechanism which, as we shall see, is dependent on a

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