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

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Abstract
This test shows marked retardation in bilirubin excretion by the liver, after I.V. administration of whole India Ink (I.I.) and the shellac fraction, but not with a carbon suspension. Carbon tetrachloride, and ethanol cause a similar retardation. The effect of I. I. on the liver is caused by: (1) micro-infarction due to obstruction of the sinusoids by I. I.-laden Kupffer cells, an effect not detectable by the bilirubin overload test; and, (2) the effect of the shellac which causes an abnormal bilirubin test but only minimal histological damage.

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