Abstract
In view of the wide occurrence of phosphatase in other tissues than bone, the possibility of non-osseous origin of some of the serum phosphatase deserves examination. It receives support from the evidence of the great decrease of serum phosphatase after prolonged fasting 1 and its great increase after ingestion of dextrin. 2 The significance of phenomena of normal physiology has frequently been suggested by a disturbance of the function of a given organ or tissue; we believe that the increase of serum phosphatase in jaundice is of similar importance and indicates that liver is a source of serum phosphatase, normally as well as pathologically.
The procedure for determination of serum phosphatase has been described.3∗ The icteric index was determined by Meulengracht's method.
Results. Serum phosphatase was increased in about 50 observed cases of jaundice, with the exception of some cases of anemia.
In acute catarrhal jaundice bile pigments elaborated in the liver, and phosphatase, presumably of the same origin, were found in the serum in increased quantities. Yielding readily to treatment, this condition was particularly suitable for a demonstration of the decline of the serum phosphatase from its high initial values (Table I). Other clinical conditions associated with jaundice and high serum phosphatase were not equally suitable for a study from the physiological standpoint.
The decrease of the icteric index during treatment corresponded with the clinical improvement. The figures in Table I show that serum phosphatase decreased with the icteric index. It may be noted in Case 8 that not only did serum phosphatase decrease as the case improved, but that it increased during relapse.
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