Studies on the Me­chanism of Bile Pigment Formation in Vivo. Part Ⅰ. On the Cor­relation between the Production of Bile Pigments and Functions of the Parenchymal Cells of the Liver.

Abstract

1. In normal adults and in patients of non-hepatic diseases a transient hyperbilirubinemia occurs after peroral administration of hemolysed blood. 2. In cases of severe anchylostomiasis the serum bilirubin displays a remarkable decrease, and on imposition of hemolysed blood, no hyperbilirubinemia occurs but a relative one may be seen. 3. In patients with highly impaired functions of the parenchymal cells of the liver, neither absolute nor relative hyperbilirubinemia occurs on similar imposition of hemolysed blood. 4. Imposed blood or hemoglobin seems primarily to be phagocytosed by the reticulo-endothelial system. 5. A similar transient hyperbilirubinemia is also seen in rabbits after peroral imposition of hemohsed blood. 6. When the functions of the reticulo-endothelial system are accelerated by administration of &#34;Koha&#34;, even incases of nonimposition of blood a hyperbilirubinemia occurs, but when hemolysed blood is imposed an additional transient increase in the hyperbilirubinemia may be detected. 7. In cases of blockage of the reticulo- endothelial system, this degree in the occurrence of hyperbilirubinemia is somewhat lower. 8. In cases of impaired liver cells by carbon tetrachloride, this decline is especially remarkable, and only a tendency of occurence can be dected. Since it is very difficult to explain this fact only by the co-existing impairment in the reticulo-endothelial system, the decline in the functions of the parenchymal cells of the liver must be placed under consideration. 9. By absorption tests of the intestines and by serological procedures, it is apparent that the perorally administerred hemoglobin may be readily absorbed from the jejunum, under any of these conditions. 10. Consequently, as for the cause of the hyperbilirubinemia occurring after peroral administration of hemolysed blood, most naturaly the reticulo-endothelial system participates, but it is impossible to neglect the part payed by the parenchymal cells of the liver.</p