Acholuric Jaundice

ACHOLURIC JAUNDICE, unlike mechanical jaundice, has in its pathogenesis pathological changes in the blood due to abnormal function of the reticuloendothelial system and spleen. Symptoms of A. j.: jaundice without signs of intoxication, absence of bilirubinuria and bile acids in urine, in the presence of urobilinuria; increased bilirubin content in blood and hemoglobinuria due to fragility of erythrocytes (decreased resistance); bile pigments in duodenal juice and feces; enlargement of the spleen. Causes of A. j. are considered to be disease of the spleen (Minkowski's theory), dystrophy of erythrocytes (Widal), primary intravascular hemolysis and the resulting fragility of erythrocytes (Chauffard). Jaundice is of hepatogenous origin (Minkowski, Eppinger, Chauffard); Widal considers it to be anhepatogenous. A. j. occurs in progressive malignant anemia and in a special form, so-called, chronic hemolytic jaundice (splenomegalic, hereditary or acquired).