THE RELATION OF THE SPLEEN TO BLOOD DESTRUCTION AND REGENERATION AND TO HEMOLYTIC JAUNDICE : XII. THE IMPORTANCE IN THE PRODUCTION OF HEMOLYTIC JAUNDICE OF THE PATH OF HEMOGLOBIN TO THE LIVER.

摘要

These experiments indicate, therefore, that when hemoglobin is set free in the portal circulation a larger amount is held by the liver and converted rapidly into bile pigment than is the case when it is set free in the general circulation, and that, under the former condition, over-loading of the liver with bile pigment more readily occurs and jaundice is more apt to develop. This mechanical influence must, therefore, be a factor in the lessened tendency after splenctomy to the jaundice which follows blood destruction due to hemolytic agents, for whether the spleen be an active factor in destroying the erythrocytes or whether it plays merely a passive part as a place for the deposition of the disintegrating cells, there can be no question that in this organ, when it is present, a large number of cells undergo their final disintegration after the action of hemolytic poisons, and that the hemoglobin there liberated passes by the portal system directly to the liver. When the spleen is removed, this disintegration occurs in other organs, notably in the lymph nodes and bone marrow, and the hemoglobin from these organs passes not into the portal but into the general circulation, from which it reaches the liver more gradually and in a more dilute form.