Haemoglobin which is not retained in the liver, bile pigments and
salts of bile acids circulating in the blood, have to be eliminated by the
kidneys and thus give rise to a complex or symptoms due to affections
of the kidneys: (1) haemoglobinuria, (2) albuminuria, (3) choluria,
(4) haematuria. 4

(1) Albuminuria was found in slight cases of haemolvsis as a
consequence of the increased blood destruction. The most striking
and common symptom of haemolysis (besides jaundice) is the appearance
of haemoglobin in the urine. Subsequently the latter becomes stained
from a slight to a deep dark red colour. :


If the inflammation of the kidneys is acute, epithelial cells may be
found in the urine, and a more intense destruction of them (1 siti is
followed by the escape of blood cells into the tubuli (haematuria). In
such cases the quantity of urine is very small (anuria, uraemia), and
death is the general exitus. (Compare the following examples.)

Clinical symptoms resulting from the affection of spleen and bone
marrow have not yet been recorded.
The leading idea for the above classification of the symptoms of
haemolysis is the physiological course of life, function, and death of a
red blood corpuscle. It enables us to derive the following symptoms
of intensity and chronological succession of the clinical symptoms of
haemolysis, which are in accordance with the recorded facts :—

1. Very slight destruction of erythrocytes. Very small decrease
of their number and volume is the onlysymptom. (Eventually
slight albuminuria).
* Kretz, Lubarsch-Ostertag, Ergebu. 8, UI, 495, 1902.
106


i)


. Considerable haemolysis and decrease of the number of
ervthrocytes. Super-production of bile. Transmission of
bile pigments into the blood, icterus.
