Journal of Okayama Medical Association
Published by Okayama Medical Association

<Availability>
Full-text articles are available 3 years after publication.

所謂加答児性黄疽Ⅱ, Ⅲ型 (H.Eppinger,) の成因に関する研究 第一編 所謂加答児性黄疸Ⅱ, Ⅲ型 (H.Eppinger,) の臨床的観察

Nishimura, Atsushi
70_3273.pdf 745 KB
Abstract
The clinical observations were performed on the 24 cases of the II type and the cases of the III type of so called catarrhal jaundice. And the resuts are as follows: 1. The II type of so called catarrhal jaundice is mostly seen in the third and fourth decades and the III type of so called catarrhal jaundice is mostly seen in the fifth and sixth decades. And the both two types are mostly seen in male. 2. Both two types are occured on the epidemic period of epidemic infectious hepatitis and some of them clearly seem to be a family infection and it is proved that both two types have a possibility to occur as a atypical form of epidemic infectious hepatitis. 3. There are no paticular anamnesis. 4. The cases supposed to be caused by surfeit and overwork are below 50% in the II type. and 50% in the III type. 5. The preceding symptoms are slight, but are observed on the 14 cases among the 24 cases of the II type and on the 5 cases among the 6 cases of the III type. 6. As the first symptoms, fever is observed on a half of the II type but dark urine or the yellowish coloration of skin and conjunctiva are rather remarkably observed on a half of the III type than fever. 7. The chief complaints are the yellowish coloration of skin and conjunctiva and gastrointestinal complaints, besides, itching of skin. Those complaints are observed on the one third cases of the II type and on the 5 cases among the 6 cases of the III type. 8. The fever type is not always agreed with the reports of H. Eppinger. It is significant that the fever is caused by the infection of cholangitis etc. during the course of this type. 9. The star like dilatation of peripheral vessels is sometimes observed during the course of both two types. 10. Anemia is observed on the palpebral conjunctiva and the blood picture during the course in a half cases of both two types especially the III type. 11. Hepatomegaly is often observed, but no paticular differences are observed between both two types. Splenomegaly is not remarkably huge in the cases of the II type and is also observed to be enlarged in the cases of the III type. This is not agreed with the reports of H. Eppinger. It is however, noticed that the enlargement of the splenic dullness is observed as the common cases as epidemic infectious hepatitis. 12. Both ascites and edema are observed on the cases with a prolonged course and poor prognosis. 13. It is significant that, despite the relative neutrocytosis with a shift to the left is remarkable the relative lymphocytosis and monocytosis are slight. These findings are, howe. ver, not special for both two types and are caused by the complication of cholangitis. 14. The excreation of bile is markedly obstructed on the liver function and the slight impediment of liver parenchyma is also observed. 15. Most of both two types have a long standing jaundice, prolonged course and poor prognosis. The recurrences are observed on the 3 cases among the 24 cases of the II type, even the cases showing the improvement of the course fortunately, and two of them are dead. 16. The results of surgical treatment, as the treatment of both two types, are observed. Operation is carried out the 5 cases of the II type and the 4 cases of the III type, and the effective results are seen in the 4 cases of the II type and in all the cases of the III type.
ISSN
0030-1558
NCID
AN00032489