When the common bile-duct is permanently obstructed or jaundice becomes persistent and deep, cerebral symptoms, such as mental irritability and depression, and later coma, delirium, or convulsions, and a slow pulse and subcutaneous hemorrhages develop. These are symptoms, at least in part, of poisoning caused by fermentation and putrefaction of the contents of the intestines, and by the failure of the liver to eliminate the toxins or to prevent their gaining access to the central nervous system.

As soon as it is demonstrated that the cause of a jaundice cannot be removed, food should be prescribed in small amounts and of a character that will neither make great bulk in the intestines nor be liable to rapid putrefaction, so as to avert such poisoning and prolong life. Nothing meets these conditions so well as milk. Just as in uremia, an exclusive milk diet is best.

The skin should be kept clean and active by frequent hot baths and by rubbing. An abundance of fresh air should be furnished the patient.

Water should be drunk freely, so that elimination by the kidneys may be stimulated. Some of the toxins that will of necessity find their way through the liver into the general circulation may be eliminated by the skin and the kidneys. If the kidneys cannot be kept active by the milk and water taken by the mouth, therapeutic salt solution must be given by the rectum or hypodermically. Dietetic treatment, as well as medicinal treatment, is in these cases protective rather than curative.