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June 12, 1937


JAMA. 1937;108(24):2043-2044. doi:10.1001/jama.1937.02780240035013

Few problems have so seriously concerned students of hepatic physiology as those concerned with the disturbed mechanisms of coagulation associated with jaundice or hepatic injury. Studies on the subject have been handicapped by preconceived ideas in regard to the effect of the constituents of regurgitated bile on the blood itself, but it is now apparent that the bile pigments, the bile salts or the cholesterol present in jaundiced blood have no particular effect on coagulation of blood and that some disturbance in hepatic function is the determining factor. Disturbances in coagulation of blood therefore must depend on a deficiency of some substance normally supplied by or stored in the liver or on some hypothetical anticoagulant derived from degenerating hepatic cells. The first hypothesis recently has been supported by new and valuable evidence.

The theory of blood coagulation now in general favor is that of Wöhlisch. According to this, a clot

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