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It is shown from the literature and new experiments that the liver is the exclusive site of urea formation and the chief site for the deaminization of amino acids. But a small amount of liver tissue is adequate, so that in cirrhosis of the liver and feeding ammonia, although high blood ammonia values were observed in eighty-two cases, it does not indicate any inadequacy of the liver but may be due to an anastomosis between the portal vein and the vena cava. In acute hepatitis and obstructive jaundice and some other liver diseases there was no abnormal increase in blood ammonia on the feeding of ammonia. Folin's colorimetric method for amino nitrogen determination was shown to give very low values and therefore was discarded. After ingestion of 25 Gm. of aminoacetic acid, amino nitrogen was determined in the blood plasma by the Van Slyke method in twenty-two normal subjects, fifteen
Amino Acid and Ammonia Metabolism in Liver Diseases. JAMA. 1936;107(25):2079. doi:10.1001/jama.1936.02770510069039