Red blood cells are hemolyzed by various agents, such as saponin,1 cobra venom2 and mushroom toxins,3 both in vivo and in vitro. The blood serum has the power of protecting the red cells against greater concentrations of these agents than the cells can withstand alone. Bile salts have the property of hemolyzing red blood cells, and the red cells are protected against such hemolysis by their blood serum.4 Of all the various hemolytic agents, the bile salts are the most interesting from a clinical point of view because of the question as to whether or not bile salts existing in the blood stream as the result of hepatic obstruction may cause hemolysis. Ponder has contributed an immense amount of painstaking work on this phenomenon.
Donnelly and Mitchell5 found that the degree of the hemolyzing power of bile salts for normal red blood cells, as well
SANFORD HN, CRANE MM, LESLIE EI. BILE SALT HEMOLYSIS IN NEW-BORN INFANTS AND ITS INHIBITION BY THE BLOOD SERUM. Am J Dis Child. 1930;40(5):1039-1044. doi:10.1001/archpedi.1930.01940050101012