Observations placeholder

As described in Illustrations Of The Influence Of The Mind Upon The Body In Health And Disease, Designed To Elucidate The Action Of The Imagination - Daniel Hack Tuke, M.D., M.R.C.P.,

PART II. THE EMOTIONS.
CHAPTER IX. INFLUENCE OF THE EMOTIONS UPON THE INVOLUNTARY MUSCLES.

This appears to be the proper place to refer to those cases of icterus, which probably arise from spasm of the gall-duct. Dr. Watson says,

"Certainly the pathemata mentis play their assigned parts; fits of Anger and of Fear and of alarm have been presently followed by jaundice. . . Mr. North witnessed a case in which an unmarried female, on its being accidentally disclosed that she had borne children, became in a very short time yellow.
A young medical friend of mine had a severe attack of intense jaundice, which could be traced to nothing else than his great and needless anxiety about an approaching examination before the Censors' Board at the College of Physicians. There are scores of instances on record to the same effect."

Dr. Watson seems inclined to connect the icteric and mental symptoms with spasmodic constriction of the gall-ducts, and does not adopt Mr. Mayo's suggestion that jaundice in such cases is due to the influence propagated through the nerves causing the formation of bile in unusual and rapid amount in the blood (Principles and Practice of Medicine. By Dr. Thomas Watson, II, p. 557).

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In the "British Medical Journal" for Nov. 19, 1870, is the report of a case of " Jaundice after Anxiety," by Mr. T. Churton, of Erith:

"A married lady, set. 30, had an attack of jaundice, October, 1868, after mental and physical fatigue. The ordinary remedies were used, the nitro-muriatic acid being the most useful, but the discoloration persisted for some weeks. Six months afterwards she had another attack, which appeared to arise from similar causes. She had several visitors staying in the house, and having little inclination for society, was somewhat disturbed by attending to them, and by the addition to the ordinary cares of the household. In the midst of this anxiety, one of her children, subject to asthma, had a severe attack one evening, and was in considerable distress all night. Next morning at five o'clock, I found her sitting up in bed, rocking to and fro, and complaining of acute pain in the hepatic and gastric regions. Pulse 72; temperature 98.4 deg. She showed slight but unmistakable symptoms of hysteria — quivering eyelids, &c. Ten grains of bromide of potassium were given, therefore, every four hours. The first dose cured her of all pain at once. On the following day, however, I found her completely jaundiced, and the urine of a dark brandy color. The bromide was continued, but less frequently, and an aperient given.

Next day the jaundice was less intense. Two days after, the yellowness had entirely gone, and the urine was of a natural color."

Mr. Churton adds, — " I do not pretend that the aperient pill had nothing to do with this rapid recovery, but, on the other hand, we know how little purgatives avail in such cases. Neither do I think they would have availed anything in this case, had not that condition of the nerve-centres upon which (no matter how) the jaundice ultimately depended, been first, as it were, neutralized by the bromide. Nevertheless, I should have laid little stress on a single case but that Mr. Jessop, of Leeds, to whom I am indebted for the suggestion of this plan of treating nervous jaundice, tells me that he has several times used the bromide with equal success."