Bilirubin Metabolism in the Newborn: Its Mechanisms and Relationship to Kernicterus

  • Leo Stern


Although jaundice as a sign of disease was known to both Galen and Hippocrates, the earliest record of its mention in relationship to the newborn is in Bartholomeus Metlinger’s1 book Ein Regiment der Jungen Kinder, published in 1473. In 1708 Michael Ettmuller2, in his treatise De Infantum Morbis, mentioned jaundice which appeared shortly after birth. He recommended feeding the affected infant saffron with breast milk several times daily. In 1751 John Burton’s3 An Essay Towards a Complete New System of Midwifry, Theoretical and Practical contained the following description and therapeutic annotation:

“The want of Respiration to squeeze forward the Bile, and the Resistance made to its Entry into the Guts of Foetuses by the tough Slime which lines the Intestinal tube make the Effusion of their Bile very slow, and therefore their Gallbladder is generally full of green Bile. Hence at birth or soon after, Children are often observed to have the Jaundice, the thick Slime produces the same Effect in them, as if Stones or the Gravel obstructed the Neck of the Gallbladder. The Jaundice generally yields to any gentle Purgative, and very often is carried away by any Medicine that increases the Contraction of the Gut, which is no more than might be expected from understanding the cause of the disease.”


Enterohepatic Circulation Serum Bilirubin Level Unconjugated Bilirubin Neonatal Hyperbilirubinemia Glucuronide Formation 
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Copyright information

© Springer Science+Business Media New York 1984

Authors and Affiliations

  • Leo Stern
    • 1
  1. 1.Brown UniversityProvidenceUSA

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