Takata-Ara Reaction in Obstructive Jaundice

The test that Takata 1 proposed was originally used to distinguish between lobar and lobular pneumonia and he reported the reaction with Ara 2 at this time on the serum in pneumonia and in cerebral spinal fluid as well, where it seemed to be of value in distinguishing between meningitis and luetic involvement of the central nervous system. The reason for the reaction was probably a protein-shift in the blood, according to most investigators and knowing that this occurs in many pathological conditions, Jezler, 3 , 4 , 5 Staub 6 and others employed the test upon serum or ascitic fluid in liver disease. They found that the test was positive in cases of advanced liver cirrhosis and also in cases of severe toxic parenchymal damage.

Recently, Heath and King 7 have reported a series of over 400 cases with results which, in general, corroborate these findings. They have obtained positive tests of over 60% of cases of cirrhosis of the liver and also in cases of marked liver damage. They did not, however, get positive reactions in cases of biliary obstruction of the extra-hepatic type.

Having at hand 2 cases where a positive reaction was obtained from serum taken from cases of acute extra-hepatic Mary obstruction due to stones, we made observations on a series of dogs in which the extra-hepatic biliary system had been blocked by ligating the common bile duct. These animals, after operation, were given a balanced diet and blood was drawn weekly for examination. Of a total of 8 animals, 4 were obstructed by common duct ligation and 4 observed as controls. None of the 4 controls exhibited at any time a positive reaction either in serum or plasma. In the 4 animals jaundiced by occlusion of the common bile ducts, jaundice ensued within a few days, gradually deepening during the first 3 weeks, then maintaining a more or less constant level after this time.