A yellow discoloration of the skin,  sclerae and other tissues due to excess circulating bilirubin.
 
 
This problem is a symptom and not a disease in itself. Careful differential diagnosis will elucidate the cause and thus the core treatment 
needed.  However,  a number of plants can have a direct effect upon the metabolism and build up of bilirubin in the body.  These can be used 
to ease the discomfort whilst focusing upon the underlying cause.
 	
 A review of the complexities of bilirubin metabolism shows the 
range of pathologies that can underlie jaundice.  Accurate differential diagnosis goes beyond the level of biochemical and technical sophistication
 that is appropriate for this course.
 	
 The commonest cause is described as Cholestasis,  itself caused by a range of processes.  
It describes a state where there is an impaired flow of bile.  This will lead to a back up behind the blockage and so the development of jaundice.
The cause of the blockage must be sort.  It could be due to inflamed tissue swelling,  ducts blocked by gall stones,  cancer or even parasites.
 
 Actions indicated for the processes behind Jaundice:
 Cholagogues are remedies that have a direct upon
 the secretion and release of bile.
 Hepatics have a positive metabolic effect upon liver metabolism and functioning.
 
Bitters will help as tonics that also often supply the previous actions.
 "Eliminative support" must be given to
 help the body as a whole deal with the build of bilirubin as well as other metabolites. Laxatives,  diuretics and diaphoretics are the most 
important ones to consider.
 Alteratives/Tonics will support the body as a whole in its healing work.
 Lymphatics 
support the tissue drainage work of this important system.
 Anti-pruritics will ease the often intense itching.
 
Anti-microbials will be crucial if there is an infectious basis to the jaundice.  They will still be helpful as surface immune support 
even if there is no infection present.
 
 System Support
 The liver,  digestion and circulation are primarily important,  
but due to the often unclear etiology as well as the body wide effects of the bilirubin, general toning is called for.
 
 Specific Remedies 
 Traditionally in Europe,  Dandelion root and Vervain are considered specifics.  Many of the bitter hepatic/cholagogue could 
be considered specific. The hepato-regenerative potentials of Milk Thistle  must be taken advantage of to ensure there is no
 hepato-toxicity due to backed up bile. Please also review Fringetree Bark,  Black Root & Balmony.
 
  
One possible prescription
 
-  Dandelion root -	2 parts
 
-  Vervain	-	1 part
 
-  Milk Thistle -	
1 part
 
-  Fringetree Bark	-1 part
 
-  Boldo	-	1 part   	as tincture to 2.5ml three 	
						times a day,  building up to 5 
							ml three times a day.
 
     
 Infusion of Chickweed or Distilled Witch Hazel applied topically to reduce itching..
This 
supplies the range of actions needed as well as specific help:
 
 
-  Hepatics (
 Dandelion root,  Vervain,  
Milk Thistle, Fringetree Bark,   Boldo)
  
-  Bitters
  (Dandelion root,  Boldo)
 
 
-  Alteratives/Tonics (
 Dandelionoroot,  Boldo
  
-  Anti-pruritics
  (Chickweed)
 
 
Broader Context of Treatment 
This will,  of course depend upon the nature of the diagnosis.