The fragility of erythrocytes in obstructive jaundice and pernicious anemia

Our previous work demonstrating the action of small amounts of hemolytic substances as castor oil soap and saponin in decreasing and increasing the fragility of red blood cells would seem to have some bearing upon the fragility test as used in medical diagnosis. The preliminary work to determine the rôle of adsorption hemolysis in clinical conditions is here reported.

Bile from various animals has been used as a hemolytic agent for various animal erythrocytes and we have found its action to be very variable in different samples. The surface tension of bile solutions has also been studied and its surface tension, reducing property is likewise very variable.

There is a very marked relation between the time of hemolysis and relative surface tension. Some samples of bile have shown a decrease in surface tension upon dilution with salt solution and coördinate with this has occurred a decrease in the time of hemolysis. When erythrocytes are treated with non-hemolytic concentrations of bile, the fragility of the cells are sometimes greatly decreased and sometimes increased. This corresponds with clinical findings and adsorption of bile elements on the surface of the red blood cells appears responsible for the changes in fragility observed.

In pernicious anemia a decreased or normal fragility of red blood cells is found. W. P. Larson suggested some years ago to the author that the hemolytic agent was probably a substance with a marked surface tension reducing property. In our experiments we determined carefully by means of a time-fragility test the fragility of the cells from pernicious anemia and the fragility of normal human cells from a blood of the same group. The normal cells were then treated with the serum from the pernicious anemia patient for varying lengths of time.