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June 3, 1916


JAMA. 1916;LXVI(23):1780-1781. doi:10.1001/jama.1916.02580490028012

Among the positive results which have been described as a sequel to the removal of the spleen are not only an increased resistance of the red blood cells but also a decreased tendency to the jaundice that follows the destruction of these cells by hemolytic agents. The spleen is regarded by many investigators as the natural location for the disintegration of erythrocytes after administration of hemolytic poisons.1 The hemoglobin there liberated is carried directly by the portal system to the liver, where it may be in large measure removed, converted into bile pigment, and thereupon excreted in the bile. It is readily conceivable that if liberated hemoglobin is thus present in large quantity, some of it may escape this sequence of events; and the pigment appearing in the tissues and the urine may thus produce jaundice. Inasmuch as after splenectomy the occurrence of jaundice of this sort appears to

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