Etiology.—It is not positively known what causes give rise to temporary or evanescent icterus in the new-born. Some have attributed it to a reduction of blood-pressure in the hepatic capillaries due to arrest of the umbilical circulation, while others attribute it to stasis in the smaller bile-ducts, which are compressed by the distended radicles of the portal vein.
The severe form of jaundice may be due to congenital closure or absence of the common or hepatic duct, to hepatic syphilis of congenital form, or to septic infection due to phlebitis or the umbilical vein.
Symptoms.—Jaundice is quite common in the new-born, affecting boys more than girls, and is said to occur more frequently in children born after chloroform narcosis of the mother, though an experience of twenty-five years does not confirm this view.
It generally makes its appearance on the second or third day, the skin becoming of a yellowish hue of various shades. The child may be quite drowsy for several days, although otherwise there seems to be but little functional disturbance, the child nursing as usual and digesting what is taken into the stomach. The urine is highly colored, staining the napkin and clothing with which it comes in contact. After the bowels are emptied of the meconium, the feces become colorless, as in older patients. The discoloration continues from one to three or four weeks, usually disappearing the second week.
In the severe form, the icteric hue may not appear for several days, but gradually increases in intensity, the skin assuming a bronze or yellowish-green color. The abdomen becomes full and tumid, owing to congestion of the liver and spleen. Although the child nurses well for a time, it is soon apparent that digestion and assimilation are impaired, the child assuming an aged and wrinkled appearance. Hemorrhage from the cord may occur, which early terminates the life of the little patient.
When due to syphilis, there are the usual symptoms that accompany this affection; namely, snuffles, skin eruptions, fissures at the angles of the mouth, and enlarged liver and spleen.
Prognosis.—The mild or simple form is favorable, usually terminating in ten days to two weeks. The severe form, however, is generally grave, the disease terminating fatally.
Treatment.—But little treatment is necessary. Chionanthus will clear up the skin a little earlier than if the condition is left to nature, and for this reason should be used.
When due to syphilis, echinacea will be our best agent.
The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.