The Bilirubin Overload Test with Special Reference to Liver Damage Produced by India Ink. ∗

Summary

The bilirubin overload test is described and the result obtained with a variety of hepatotoxic agents is presented. Hepatic injury can be demonstrated at a very early stage, but the test is of no value in indicating degree of histological liver damage. The biological effect of whole India Ink on the liver can be divided into: 1) Micro-infarction due to obstruction of the sinusoids by India Ink-laden Kupffer cells, an effect not detectable by the bilirubin overload test; and, 2) effect of the shellac which causes only minimal histological damage but which gives an abnormal bilirubin test.