THE RELATION OF THE SPLEEN TO BLOOD DESTRUCTION AND REGENERATION AND TO HEMOLYTIC JAUNDICE : III. THE CHANGES IN THE BLOOD FOLLOWING SPLENECTOMY AND THEIR RELATION TO THE PRODUCTION OF HEMOLYTIC JAUNDICE.

The results of this study of the changes in the blood after splenectomy and of the effect of the administration of hemolytic serum allow the following tentative conclusions: 1. The failure of a hemolytic serum to cause jaundice is due in some way to the anemia which frequently follows splenectomy. Animals, whether splenectomized or not, which have a low blood count and low hemoglobin content do not readily develop jaundice after administration of a hemolytic serum. On the other hand, in animals with a normal blood picture such a serum readily causes, during early periods after splenectomy, a well marked jaundice. 2. The difficulty of producing hemoglobinemia and jaundice in animals splenectomized one month or more, is due, as shown by blood count, the use of hypotonic salt solution test, and by the search for the presence of hemoglobin in the serum and urine, to an increase in the resistance of the red cells. The results of detailed serologic tests upon this point will be presented later. 3. It is possible that spontaneous jaundice occurring at long periods after splenectomy is an accompaniment of the complete regeneration of the blood. The study of the blood in animals splenectomized for long periods, seven to ten months, indicates that spontaneous jaundice occurs only when the animal has recovered from the initial period of anemia and has a high red cell count and high hemoglobin content. 4. As to the mechanism responsible for the anemia following splenectomy and for the increased resistance of the red cells, we can at present offer no explanation.