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Case Study

And What Pray, Is Jaundice?
Dr Manu Kothari
Dr Lopa Mehta
'Chel / Castor

Jaundice is not a disease. To start with it is never a disease and hence no symptom either. It is at best a sign. No wonder Sir William Osler, our modern Hippocrates, aphorized: Jaundice is the disease that your friends diagnose. Did the childhood rhyming of words - "Yellow yellow, dirty fellow" have its origin in yellowed eyes that a friend/visitor noticed?

Talking about jaundiced phraseology, the one with universal appeal is: 'a jaundiced eye': a common conviction for which no proof is forthcoming. Lucretius (the prechristian rationalist in the line of Socrates and Aristotle) in his remarkable poetic creation De Rerum natura or On The Nature Of Things, provided an explanation for jaundiced vision: "Jaundiced persons see everything a greenish-yellow, because many seeds of this greenish-yellow colour stream out from their bodies to meet the images of things, and besides many are mingled in their own eyes which by their contact paint everything with lurid hues."

Dictionaries make clear the prejudicial-"disfavour, disgust or disillusion" - nature of a jaundiced eye: "A prejudiced eye which only sees faults. It was a popular belief that to the eye of a person who had jaundice, everything looks yellow." Alexander Pope, crippled, hypercriticized, measuring a mere 54", poetically echoed Lucretius: All seems infected that the infected spy. As all looks yellow to the jaundiced eye. It's just possible that Pope was caricatured, criticized, reviled and lampooned as much for his greatness as a poet as for his vicious satire (thus nicknamed the "wicked wasp of Twickenham") could have fashioned the above lines to size up his tormenting critics.

The term Jaundice originates from the French Jaune meaning yellow, and jaunice meaning yellowness. And no more than that. Hence the pseudojaundice that can result from drinking gallons of carrot juice resulting in excess of carotene in the blood, part of it spreading it to the eyes to paint them yellow.

Then there is physiological jaundice or icterus neonatorum that appears soon after birth as a result of the deficiencies of the liver enzymes responsible for making insoluble billirubin soluble by conjugating it with glucuronic acid. "Physiological jaundice is therefore common in the first 7 days of life. It usually appears on the second or third day of life and then fades." All humans paint themselves yellow at birth.

The burden of this entire issue is pathological jaundice, a symptom of deranged bilirubin metabolism and or circulation. Allopaths go by the general rule of thumb-Is it "surgical" or "medical"? If medical, just nurse the patient, withdraw noxious hepatotoxic drugs (these days rifampicin for TB being the commonest), "support" the liver, and pray. And, thank God, for he largely answers the prayers. If surgical, remove the cause, which has a bewildering variety, and/or create a bypass. Modern medicine's faith in such concoctions as Liv 52 can be amazing.

We know naught if the Hahnemannian's are given to aggravating Jaundice-of whichever origin-before curing it. Given liver's sturdiness, it will be difficult to think of agents that can be willfully presented to worsen jaundice so that it then declines. Jaundice is a classical example of a mere sign being viewed and described as a disease. But that's how modern medicine works. How many of the doctors would admit and patients would accept that so often, high blood pressure/sugar, or a tumor are mere sins and no dis-ease?