22 Scientific Proceedings (69). 



15 (1079) 



Icterus. A rapid change of hemoglobin to bile pigment in the 

 pleural and peritoneal cavities. 



By C. W. Hooper, M.D., and G. H. Whipple, M.D. 



[From the George Williams Hooper Foundation for Medical Research, 

 University of California, San Francisco.] 



In an earlier communication we have been able to show that 

 bile pigment could be formed from hemoglobin without the 

 agency of the liver. Solutions of hemoglobin were introduced 

 into the blood vessels of dogs whose livers had been excluded 

 from any part in this reaction. There was a prompt formation 

 of bile pigment from hemoglobin with no possible direct liver 

 action. This transformation can take place within a space of 

 two hours when active circulation is maintained in the head 

 and thorax alone. It seemed probable that the endothelium might 

 be the tissue whose activity was responsible for this change of 

 hemoglobin to bile pigments. This work has received confirma- 

 tion from experiments of McNee. 



All our experiments were performed on normal dogs. Hemo- 

 globin in crystalline form dissolved in salt solution or obtained 

 from freshly laked red blood corpuscles was introduced into the 

 pleural or peritoneal cavities. The fluid was withdrawn after 

 different intervals varying from eight hours to three days. Care- 

 ful tests showed at times some bile pigment formation in eight 

 hours but always in twenty-four hours — often in sufficient amounts 

 to be estimated quantitatively. The amount of bile pigment 

 formation is considerable after an interval of two, three, or four 

 days — even more than five milligrams in some cases. It is to 

 be recalled that a dog of thirty pounds in weight may excrete 

 normally about 25 milligrams of bile pigment in six hours. 



There is very good evidence that bile pigments may be formed 

 from hemoglobin by the agency of endothelial cells. There is 

 conclusive evidence that bile pigments can be formed by the 

 mesothelium of the serous cavities. It is possible that this 

 capacity of transforming hemoglobin into bile pigments may be 

 a general property of living protoplasm. 



