Further studies of the Van den Bergh reaction

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Abstract
The rates of azobilirubin production from bilirubin-containing body fluids on treatment with diazo reagent were detd. In the presence of phosphate buffer, sera from patients with regur-gitation jaundice formed azobilirubin rapidly, while sera from patients with retention jaundice formed it slowly. The addition of urea to the buffer resulted in rapid formation of azobilirubin in all sera. It is suggested that the direct reaction is due to the presence of catalysts in the sera and not to the existence of different forms of bilirubin in retention and regurgitation jaundice, and that the catalytic substance may be specifically elaborated in regurgitation jaundice. It is recommended that the terms direct and indirect bilirubin be abandoned and the term direct-indirect quotient be used.

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