Grave familial jaundice of the newly born / Sir Humphry Rolleston.

  • Humphry Rolleston
Date:
[1920?]
Catalogue details

Licence: In copyright

Credit: Grave familial jaundice of the newly born / Sir Humphry Rolleston. Source: Wellcome Collection.

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    narrowing of the ducts which gives rise to obstructive cirrhosis. My own view is that a maternal toxaemia causes cirrhosis followed by a descending obliterative cholangitis; and Dr. S. Wyard suggests that there is an ascending cholangitis from the duodenum set up by the irritation exerted by the swallowed liquor amnii. Most writers agree that all cases are not necessarily due to the same mechanism. The Severe Infective Forms of Jaundice, such as those due to umbilical, cutaneous, or intestinal infection, formerly occurred in epidemics, and were responsible in the old insanitary lying-in hospitals for a terrible mortality, but, as far as I know, are rare now. The jaundice comes on about the fifth day of life, or later than in familial jaundice, and is accompanied by signs of grave septicaemia, high fever, and haemorr¬ hages especially from the umbilicus or the alimentary canal. WinckeFs disease (epidemic haemoglobinuria with bronzing of the skin) and Buhl’s disease (acute fatty degeneration) are manifestations of this sep¬ ticaemia of the newly-born, the infection probably entering from the intestines. The prognosis is very grave. Treatment should consist in the administra¬ tion of antistreptococcic serum, washing out the bowel, and the oral administration of intestinal antiseptics such as minute doses of calomel. In Melcena Neonatorum jaundice is often present; thus Pitfield records as haemophilia four successive males with jaundice and haemorrhages. Congenital Splenomegalic Haemolytic Jaundice runs a mild course, and can hardly be called a disease; it is recognized by the characteristic fragility of the red blood corpuscles when tested with hypotonic solutions of salt. Congenital syphilis does not often cause jaundice ; it usually comes on early and is accompanied by other signs of the disease such as enlargement of the liver and spleen. Secondary
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