Pigmentation. 213 



Biliary stasis may also depend upon an excessive production 

 of the secretion, inasmuch as the profusely produced bile may 

 also be sometimes too concentrated and thick and flow with 

 difficulty, the cells in consequence becoming clogged. A hyper- 

 cholia of this type occurs in conditions which cause a marked 

 destruction of red blood cells, and the haemoglobin set free 

 en masse is then worked over in the liver and renders the bile 

 particularly rich in its pigmentary matter. It is possible, too, 

 that the bile may be thickened and less fluid or may diffuse 

 directlv into the blood vessels because of disease of the liver cells. 

 This is met in a number of intoxications and infectious diseases, 

 where, as the cause of the jaundice cannot be referred to a condi- 

 tion of biliary stasis, it is spoken of as a resorption jaundiee or 

 infectious or toxic paracholia. (Pick.) 



It was formerly believed that the formation of biliary coloring matter 

 in quantities sufficient to cause jaundice could also take place outside 

 the liver, in the blood; and a hsematogenous jaundice was spoken of. 

 From the studies of Minkowski and Xaunyn, however, it may be consid- 

 ered established that, even in cases where a simple increase of destruction 

 of erythrocytes causes this symptom, it is not produced except with the 

 intervention of the liver, and that the transformation of the haemoglobin 

 into biliary pigment is accomplished in the liver. Birds jaundiced by 

 arseniuretted hydrogen rapidly lost their icterus after extirpation of the 

 liver, and where the liver had been previously ablated, jaundice could not 

 be produced in any degree at all. [The term "local hsematogenous jaun- 

 dice" is sometimes applied to the yellowish discolorations of fading bruise 

 marks; it is permissible only in a general w\ay, and in precise discus- 

 sions the pigment must be understood as not identical with the jaundice 

 pigment. Although there may be more or less hsematoidin present, there 

 are also less closely allied blood pigments.] 



The entrance of the bile into the blood is followed by an 

 impregnation of all the tissues to which the blood vessels are 

 distributed with the biliary coloring matter, this giving them a 

 biliary tint of various shades. In the living body this is apt to 

 be particularly conspicuous in the conjunctiva and sclera; in the 

 dead animal the yellow color is principall}- apparent in the stib- 

 cutaneous tissues, the fat, intermuscular connective tissue, the 

 lungs, I'ver and kidneys, the mucous membranes and their mus- 

 cular coats. Where the normal color of an organ was pale the 

 discoloration may take on an intense citron-yellow hue ; the dark 

 liver and kidney tissue becomes saffron yellow to olive green or 

 o-reenish-black. Even the bones as well as fibrinous blood clots 

 and the blood serum assume a biliary tint. As the pigment gains 



