The excretion of an abnormally large amount of bile pigment has long been recognized as an almost constant feature of pernicious anemia in relapse. Furthermore, the excretion of bile pigment has been found to return to normal after the institution of adequate treatment.1 The significance of these observations has given rise to considerable controversy. One school of thought2 holds the view that the bile pigment formed in the normal course of destruction of blood or possibly through some activity of the liver apart from that of the destruction of blood cannot be utilized for the formation of new blood in patients with pernicious anemia and hence is excreted almost quantitatively. The second school3 regards the increased excretion of bile pigment in pernicious anemia as evidence of excessive destruction of red blood cells. In this study the metabolism of bile pigment in various forms of blood dyscrasia has been
BARKER WH. EXCRETION OF BILE PIGMENT AND HEPATIC FUNCTION IN DISEASES OF THE BLOOD. Arch Intern Med (Chic). 1938;62(2):222–246. doi:https://doi.org/10.1001/archinte.1938.00180130043004
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