BILE PIGMENTS OF JAUNDICE*

Abstract

Current concepts concerning the formation and metabolism of bile pigments hold that bilirubin is formed from the catabolism of hemoglobin by the reticuloendothelial system, mainly in bone mar- row and spleen, and that the bilirubin is then transported to the liver where it is modified and ex- creted. via the biliary system. These concepts are based largely on the studies by Mann, Magath and Bollman (1, 2) of the effect of total hepatectomy on mammals which show that after complete extirpation of the liver, indirect-reacting bile pig- ment was formed and accumulated in the serum progressively during the survival period of the animal. Bollman and Mann (3) noted that as the amount of bilirubin in the blood increased after hepatectomy, the van den Bergh reaction changed from an indirect to a direct reaction and bilirubin began to appear in the urine.