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March 1917, Vol XIX, No. 3 >
ARTICLE | March 1917

THE BILE CONTENT OF THE BLOOD IN PERNICIOUS ANEMIA

M. A. BLANKENHORN, M.D.
Arch Intern Med (Chic). 1917;XIX(3):344-353. doi:10.1001/archinte.1917.00080220011002.
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The lemon yellow color of the skin in pernicious anemia has always been closely associated with the idea of jaundice and is often referred to as an icteroid hue. But the almost invariable absence of bile from the urine has stood in the way of our calling pernicious anemia patients definitely jaundiced. The frequent appearance of urobilin in the urine has suggested an explanation for the color of the skin, and we frequently see the term ``urobilin icterus'' in this connection.

Hemolysis, which is the most definite pathologic entity of pernicious anemia, is also fundamentally associated with the symptom jaundice and we are therefore enticed by the term "hemolytic jaundice" in pernicious anemia.

Just what relation exists between the appearance of bile pigments in the blood and the yellow pigmentation of the skin in pernicious anemia has been the object of this investigation.

The presence of bile in

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