In a consideration of the relation of the spleen to jaundice it must first be borne in mind that the erythrocyte is the chief source of hemoglobin from which the formation of bile pigments must originate. Therefore, the relation of the normal and the pathologic spleen to red blood cell destruction is the hub around which the entire discussion must revolve.
The spleen may destroy red blood cells by an intracellular process which is dependent on the action of the macrophages or by an extracellular action which must be distinctly a lytic process.
The formation of bile pigments in the spleen must be dependent on a definite splenic hemolysis, but to argue a hemolytic function for the spleen based on the blood picture of splenectomized animals encounters difficulties that cannot be surmounted.
In the presence of jaundice associated with a large spleen one is at once confronted with the fact
PAYNE RL. RELATION OF THE SPLEEN TO JAUNDICE. JAMA. 1930;95(15):1064-1066. doi:10.1001/jama.1930.02720150004002