If jaundice depends on the spleen alone, then this is indicated by the fact that it is not first yellow and then black, for yellow jaundice never arises from the spleen. Although black jaundice is sometimes also due to the liver, with black splenic jaundice the blackness of the face is greater and it is accompanied by signs of hardening and enlargement of the spleen, as well as pain that is felt in the left side. Feces and urine are sometimes black, and black matter often comes out in the stool; this is a strong sign of splenic jaundice. Sometimes the urine remains healthy if there is no damage to the liver and damage to the spleen has not yet spread to it to an excessive degree; in this case, the healthy condition of the liver is a sign that jaundice depends on the spleen. With this disease, the abdominal walls are tense and pain and heaviness are felt; in most cases the nature is locked up, but sometimes it becomes soft. In this case, digestion is poor and rumbling occurs frequently, the patient feels bad, melancholy and causeless anxiety appear; sometimes dark sweat is released.
Black jaundice due to blockages in the passages is indicated by severe heaviness, as well as the fact that it is difficult to sleep on the left side. In cases of jaundice due to a hot or hard tumor, signs of such tumors are observed. With jaundice due to weakness of the spleen there is no severity; if the liver is also affected by weakness, this is indicated by signs of liver weakness. A sign of liver-dependent black jaundice is primary damage that appears in the liver, and the spleen may be healthy or damaged. In this case, however, there are lesions in the liver, producing a lot of black bile, and the blackness of the face is not strong and clear, as in splenic jaundice. Poor quality urine also indicates hepatic jaundice. If its spoilage depends on warmth and dryness, then its dark color is yellow, and if it depends on warmth and humidity, then yellowness and redness with some kind of reddish tint are observed. If spoilage depends on coldness and dryness and coldness predominates, then the urine is greenish, and if dryness predominates, the urine is darkish. If spoilage depends on coldness and humidity and humidity predominates, then the urine is somewhat yellowish and pistachio-colored, and if coldness predominates, then the urine is greenish. With splenic black jaundice, the color of the urine is uniform.