Skip to main content
Log in

Treatment of the hemorrhagic tendency in jaundice; with special reference to vitamin k

  • Published:
The American Journal of Digestive Diseases

Summary and conclusions

Evidence has been presented to show that oral administration of a fat soluble vitamin and bile salts will increase the concentration of prothrombin and thereby reduce the clotting time of the blood, as measured by both direct and indirect methods. It appears that the vitamin alone will not accomplish this result if bile is excluded from the intestine, while bile or bile salts have some definite effect, presumably because these substances facilitate absorption of the vitamin which is already present in the intestinal tract. The question naturally arises as to why bile alone cannot be used in the preoperative and postoperative treatment. The first reason is, of course, that the prothrombin time may continue to rise postoperatively, even when bile is flowing freely into the intestine. As Warner, Brinkhous and Smith (23) have shown, the administration of Vitamin K greatly accelerates the restoration of prothrombin in such cases. The second is the inadequate food intake which is common to most jaundiced patients and which may of itself lead to depletion of the amount of Vitamin K in the digestive tract. The third factor has to do with the ability of the liver itself to convert the protective material into prothrombin. There is considerable clinical evidence to show that in the presence of injury of the liver larger amounts of Vitamin K are required to achieve the desired effect. Presumably, the chemical laws governing mass action are operative in this connection. A good deal of future experience will be needed before a definite statement as to the indications for and the limitations of this treatment can be established, but for the present it may be said that it offers considerable hope for the ultimate control of the hemorrhagic diathesis in jaundiced persons.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aggeler, P.M. and Lucia, S. P.: Study of Some Variables Affecting the Prothrombin Time.Proc. Soc. Exper. Biol. and Med., 38:11–16, Feb., 1938.

    CAS  Google Scholar 

  2. Almquist, H. J.: Anti-hemorrhagic Vitamin.Poultry Sc., 16:166–172, May. 1937.

    CAS  Google Scholar 

  3. Almquist. H. J.: Further Studies on the Anti-hemorrhagic Vitamin.Jour. Biol. Chem., 120:635–640, Sept., 1937.

    CAS  Google Scholar 

  4. Boland, E. W.: Pathologic Data in Cases of Jaundice and Fatal Hemorrhage.Proc. Staff Meet. Mayo Clinic, 13:70–72, Feb. 2 1938.

    Google Scholar 

  5. Bollman, J. L.: Personal communication to the authors.

  6. Butt, H. R., Snell, A. M. and Osterberg, A. E.: The Use of Vitamin K and Bile in Treatment of the Hemorrhagic Diathesis in Cases of Jaundice.Proc. Staff Meet. Mayo Clinic, 13:74–77, Feb. 2, 1938.

    Google Scholar 

  7. Dam, H.: Haemorrhages in Chicks Reared on Artificial Diets: New Deficiency Disease.Nature, 133:909–910, June 16, 1934.

    Article  CAS  Google Scholar 

  8. Dam, H.: The Anti-haemorrhagic Vitamin of the Chick: Occurrence and Chemical Nature.Nature, 135:652–653, April 27, 1935.

    Article  CAS  Google Scholar 

  9. Dam, Henrik and Glavind, Johannes: Vitamin K in Human Pathology.Lancet, 1:720–721, March 26, 1938.

    Article  Google Scholar 

  10. Dann, Flementine P.: Personal communication to the authors.

  11. Greaves, J. D. and Schmidt, C. L. A.: Nature of the Factor Concerned in Loss of Blood Coagulability of Bile Fistula Rats.Proc. Soc. Exper. Biol. and Med., 37:43–45, Oct., 1937.

    CAS  Google Scholar 

  12. Hawkins, W. B. and Brinkhous, K. M.: Prothrombin Deficiency the Cause of Bleeding in Bile Fistula Dogs.Jour, Exper. Med. 63:795–801, June 1, 1936.

    Article  Google Scholar 

  13. Judd. E. S. and Wangensteen, O. H.: Unpublished data.

  14. Magath, T. B.: Coagulation of Blood with Special Reference to Prothrombin.Proc. Staff Meet. Mayo Clinic, 13:67–69, Feb. 2, 1938.

    Google Scholar 

  15. Nygaard. K. K.: Coagulability of Blood Plasma: a Method of Determining Hemorrhagic Tendency of Jaundiced Patients.Proc. Staff Meet. Mayo Clinic. 7:691–696, Nov. SO, 1932.

    Google Scholar 

  16. Osterberg, A. E.: Vitamin K: Its Distribution and Chemical Properties: Methods of Preparation and Assay.Proc. Staff Meet. Mayo Clinic. 13:72–74, Feb. 2, 1938.

    CAS  Google Scholar 

  17. Patek, A. J., {jrJr.} and Taylor, F. H. L.: Hemophilia. II. Some Properties of a Substance Obtained from Normal Human Plasma Effective in Accelerating the Coagulation of Hemophilic Blood.Jour. Clin. Investigation, 16:113–124, Jan., 1937.

    Article  CAS  Google Scholar 

  18. Quick, A. J., Stanley-Brown. Margaret and Bancroft, F. W.: A Study of the Coagulation Defect in Hemophilia and in Jaundice.Am. Jour. Med. Sc., 190:501–511, Oct., 1935.

    Article  Google Scholar 

  19. Roderick, L. M.: The Pathology of Sweet Clover Disease in Cattle.Jour. Am. Vet. Med. Assn., 74:314–326, Feb., 1929.

    Google Scholar 

  20. Smith, H. P., Warner, E. D. and Brinkhous, K. M.: Prothrombin Deficiency and the Bleeding Tendency in Liver Injury (Chloroform intoxication).Jour. Exper. Med., 66:801–811, Dec, 1937.

    Article  CAS  Google Scholar 

  21. Snell, A.M.: Clinical and Experimental Conditions Associated with a Deficiency of Prothrombin.Proc. Staff Meet. Mayo Clinic, 13:65–67, Feb. 2, 1938.

    Google Scholar 

  22. Warner, E. D., Brinkhous, K. M. and Smith, H. P.: A Quantitative Study on Blood Clotting: Prothrombin Fluctuations Under Experimental Conditions.Am. Jour. Physiol., 114:667–675, Feb., 1936.

    CAS  Google Scholar 

  23. Warner, E. D., Brinkhous, K. M. and Smith, H. P.: Bleeding Tendency of Obstructive Jaundice: Prothrombin Deficiency and Dietary Factors.Proc. Soc. Exper. Biol. and Med., 37:628–630, Jan.. 1938.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Read before the meeting of the American Gastro-Enterological Association, Atlantic City, New Jersey, May 2-3, 1938.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Snell, A.M., Butt, H.R. & OSterberg, A.E. Treatment of the hemorrhagic tendency in jaundice; with special reference to vitamin k. American Journal of Digestive Diseases 5, 590–596 (1938). https://doi.org/10.1007/BF02996480

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02996480

Keywords

Navigation