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June 11, 1938


JAMA. 1938;110(24):2011-2012. doi:10.1001/jama.1938.02790240035014

A continuous cycle of secretion and absorption of bile from the intestinal tract is apparently necessary for normal synthesis of hemoglobin. This conclusion by Hawkins and his co-workers1 of the Department of Pathology, University of Rochester School of Medicine, is drawn from a continuation of their studies of experimental bile fistula in dogs. By the fistulas which they establish the bile is drained into the right renal pelvis. From earlier studies they found that exclusion of bile from the intestinal tract by this technic led to several abnormalities. First was the development of general osteoporosis, often leading to spontaneous fractures. Physiologic analysis showed that this abnormality of bone was caused by lack of absorption of vitamin D from the intestinal tract. The lesion in bone could be prevented by the oral administration of bile. A second abnormality of major importance was a tendency to purpura, often leading to spontaneous