HEMOGLOBIN PRODUCTION IN ANEMIA AS INFLUENCED BY THE BILE FISTULA.

The presence of a renal bile fistula with escape of all bile into the urinary tract seriously impairs the capacity of an anemic dog to form new hemoglobin on standard diets. These bile fistula dogs will produce about one-half as much hemoglobin in anemia on standard diets as during earlier control periods without a bile fistula. Iron given by mouth to an anemic bile fistula dog will effect the production of about one-half the amount of new hemoglobin as in control periods. Iron given by vein to an anemic bile fistula dog will approximate the theoretical 100 per cent return of new hemoglobin. Obviously absorption is a very important factor in the utilization of iron by these dogs. The reaction to liver feeding is much like the reaction to iron feeding but we have no proof of inadequate protein digestion and absorption in these bile fistula dogs. In fact the uniform body weight and normal clinical state over periods of years speak for adequate absorption of protein digestion products. Evidence cited above supports our belief that inadequate hemoglobin production (protein formation) noted in these bile fistula dogs may be related to a disturbed liver function.