Alterations in Serum Protein as an Index of Hepatic Failure

For some time we have been interested in the changes in the protein content of the serum in hepatic disease. The basis of this interest lies in numerous clinical and experimental observations. Whipple¹found that the liver produces fibrinogen. Less conclusively other experiments have indicated that the liver is the site of formation of the albumin of serum. Clinical observations and studies show that there are changes in the protein content of the blood in hepatic disease. This fact was first observed by Grenet²and Gilbert³in 1907, who found a diminution of the total protein content of the blood in cases of cirrhosis of the liver. Filinski⁴described cases of cirrhosis in which the total protein content was decreased, chiefly in the albumin fraction, with some elevation of the globulin content. His observation, confirmed by Abrami and Wallich,⁵have received repeated verification in the