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JAMA. 1884;II(18):483-484. doi:10.1001/jama.1884.02390410007001b.
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Mrs. B., aged 41; bilious temperament; subjected for some years to occasional attacks of jaundice; active habits; of medium stature, very obese, weighing 185 pounds; sterile, hyperæmic rather than anæmic, digestive function uniformly perfect, some little dyspnœa attendant upon active exercise, but general health has been usually good. Intellect is active, bright, vivacious, and always hopeful; avocation, house-wife, and peripatetic music teacher, both riding and walking a good deal. The lipogenesis is the only apparent indication of deficient oxidation.

This lady was taken with an “ attack of jaundice,” ten weeks ago, usual symptoms; constipation, claycolored stools, nausea, slight headache, pain in the region of the liver and under shoulder-blades, itching of the skin, dizziness, and “ faint-feeling.” No fever, except an occasional slight pyrexia lasting for a few hours early in the attack. I was called to see her in the seventh week of the disease. Prescribed mercurials with rapid favorable


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