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Diagnosis of Obstructive Jaundice

John M. Beal, MD
Arch Surg. 1968;96(6):863-868. doi:10.1001/archsurg.1968.01330240009003.
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THE diagnostic problems which are presented by icteric patients have troubled physicians for centuries. The observations of Soranus of Ephesus from the first century were translated by Caelius Aurelianus,1 a fifth century physician, as follows:

According to the Greeks, the disease of jaundice gets its name (icteros) from an animal of yellowish color. The disease occurs after prolonged indigestion or after the drinking of purgative drugs that remain within the body without being driven off.

Symptomatic of jaundice is the change to a yellowish color which first appears and is particularly noticeable in the whites of the eyes, the hollows of the soles, and the veins under the tongue. Moreover, the bowels fail to move, or whitish and clayey stools occur; and the urine is thick and saffron-colored. There is also a bitter taste in the mouth, thirst, loss of appetite,... and itching and dryness of the body... Often

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