CHAPTER XXXV
INFANTILE BILIARY CIRRHOSIS
WITHIN the last four decades a peculiar disease of the liver has been noticed in children in Calcutta and, to a less extent, in other large towns of India. It is found to be more prevalent in Hindu than in Mohammedan children. Thus, in Calcutta, from 1891 to 1893 inclusive, infantile biliary cirrhosis, the name given to this disease, caused 1,748 deaths. Although the Hindu and Mohammedan populations of that city are about equal, yet as many as 1,616 of the deaths occurred in Hindus, whilst only 80 occurred among Mohammedans, the balance of the mortality being among the Eurasians and other races. The disease occurs principally in children under one year, rarely attacking those over three years. As a rule, it commences during dentition, or about the seventh or eighth month, running a fatal course in from three to eight months. In rare cases it may commence within a few days of birth. Instead of lasting several months, its progress may be much more rapid, and terminate in death in from two to three weeks.
The cause of infantile biliary cirrhosis is quite unknown. Neither alcohol, syphilis, nor malaria has anything to do with it. The children of the well-to-do are relatively more frequently attacked than those of the poor. It has also been observed that it tends to run in families, child after child of the same parents succumbing within a year or two of birth. In 400 cases Ghose had only six recoveries; in some of these recoveries the diagnosis was doubtful.
Symptoms.— Commencing insidiously, the characteristic initial enlargement of the liver may have made considerable progress before the disease is suspected. Nausea, occasional vomiting, sallowness,
