In 10 cases of malaria (6 benign tertian, 4 malignant tertian), the excretion of urobilinogen in the stools and in the urine was studied. In all 10 cases the amount of urobilinogen excreted in the stools was found to be increased. After defervescence and disappearance of parasites from the blood the excretion gradually declined. The increased excretion of urobilinogen in the stools was the constant and sometimes the only evidence of increased blood destruction occurring at times in the complete absence of jaundice and reticulocytosis. Increased excretion of urobilinogen in the urine was not a constant feature.
It is suggested that the development of jaundice and of urobiligenuria is due not only to the liberation of pigments by the hemolysis, but to a disturbance in the liver function.
This study lends further confirmation to the concept that the only unequivocal evidence of increased blood destruction is shown in an increased output of urobilinogen in the feces.
The author is indebted to Dr. M. Rachmilewitz for his suggestions and criticisms.