Studies on Serum Protein Metabolism in Epidemic HepatitisChapter Ⅱ. A Study on Serum Picture and its Relationship with Serum Colloidal Reactions in Epidemic Hepatitis

This study in an amplification of the preceding report "the object being to trace the changes in the behaviour of serum protein in epidemic hepatitis and to classify a possible relationship between the serum protein picture and the serum colloidal reaction". For this purpose the author has estimated the serum protein for each week of illness and conducted simultaneously Takata's and cobalt hydrochloride reaction, Gros's, CCF, thymol turbidity tests, etc. For estimation of the serum protein value has been used Pulfrich's dipping refractometer; for protein fragments electrophoresis and Yosikawa-Saito’s sulphurous soda’s salt-out method. In acute hepatitis albumin and A/G was reduced from the onset. A little later on α-globulin and still later β-globulin were reduced. γ-Globulin increase appeared at an early stage and remained increased through the entire course of the illness. Its prolonged increase may be considered as a sign of transition to chronic hepatitis. In chronic hepatitis the γ-globulin increase was definite and long standing, the albumin’s decrease in protein content was insignificant. Changes found in recurrence of hepatitis were similar to these in the acute stage. The above findings have confirmed the general ideas of Rossle-Eppinger’s serous inflammation. Concerning the interrelationship between the protein picture and the results of the hepatic functional tests the following facts were found. Takata's reaction………albumin decreased, α- and γ-Globulin increased. Weltmann's reaction………albumin decreased. Cobalt-hydrochloride reaction……α- and β-globulin increased. Gros's reaction………albumin decreased, and globulin increased. Thymol turbidity test………albumin decreased, β-and α-globulin increased. Scarlet red test………γ-globulin increased. C. C. F.………γ-globulin increased. Thus especially close relationship between various reactions and tests and the protein fragments was demostrated. However, these changes in the serum protein picture cannot at once be considered to constitute the nature of these colloidal reactions. In hepatic cirrhosis the decrease in albumin and increase in γ-globulin were more marked than in hepatitis. In obstructive icterus β-globulin increase was more pronounced than in hepatitis.