The isolation of cholesterol from gallstones and its establishment as one of the characteristic components of the bile by Chevreul1 focused attention on the changes in cholesterol metabolism in hepatic and biliary disease.
The literature dealing with subsequent studies in cholesterol metabolism has been reviewed by McNee,2 Campbell,3 Muller,4 Epstein,5 Klein6 and Hurxthal and Hunt.7 There is a general agreement that the total cholesterol in the blood may be increased in disease of the biliary tract, especially in obstructive jaundice, whereas in parenchymatous hepatitis there is a fall to subnormal values.
The interpretation of changes in the blood cholesterol in relation to hepatic disease and its use in the differential diagnosis of jaundice are rendered more difficult by the fact that many other disease processes, not necessarily involving the liver, influence the blood cholesterol. Marked changes or variations from the normal are seen in such metabolic diseases as diabetes mellitus