In a case of jaundice it is of paramount importance for the surgeon to differentiate extrahepatic biliary obstruction from other causes, since the decision to operate frequently is decided by this criterion. Fairly accurate indexes for such differentiation are available, but occasionally the information obtained will be misleading. Such is the series of cases of postarsphenamine icterus reported by Hanger and Gutman.1 Their cases presented the typical clinical and laboratory evidence of obstruction to the extrahepatic biliary tract, and for that reason several of their patients were operated on. No obstruction was found in these cases, however, other than pronounced bile stasis in the canaliculi of the liver. The importance of preventing unnecessary laparotomies prompts us to draw attention again to the syndrome of intrahepatic obstructive jaundice. For this reason we wish to place on record a case which was typical of those described by the authors mentioned and