Physiologic hyperbilirubinemia during the early postnatal period has been observed by many investigators. The stimulus and justification for still another study of the phenomenon have come from improvements in methods. A simple photoelectric technic for the analysis of small samples has made it possible for the first time to record the changes in the level of bilirubin in the serum by means of daily observations on a large number of infants. In the present study such measurements were started on the first day of life after the level of bilirubin in serum from the umbilical cord had been determined. At the time of each analysis the presence or absence of clinical icterus in the infant was recorded. The data have been examined for interrelations among such factors as the concentration of bilirubin in the cord serum, the maximum intensity of the process, the age at the time the maximum level was attained, the duration of elevated levels and the presence of clinical jaundice. Ranges of normal variability have been charted for each day of the postnatal period. On the basis of the studies a significant association has emerged between the level of bilirubin in the cord serum and both the duration and the intensity of hyperbilirubinemia in the infant. The bearing of these observations on the causation of neonatal jaundice is discussed.
REVIEW OF THE LITERATUREPrevious publications dealing with the descriptive and the etiologic aspects of physiologic jaundice are numerous. Only those papers which bear directly on the results of the present investigation are referred to here.
With a few exceptions the papers and case reports dealing with epidermolysis bullosa have appeared solely in the dermatologic literature of Europe and America. Little has been written about the condition in the pediatric journals, particularly in this country. For this reason it seems worth while to report a case recently under observation in which the condition was present at birth, progressed rapidly and resulted in death after twenty-nine days.
REVIEW OF THE LITERATUREBeatty,1 in 1897, published a r\l=e'\sum\l=e'\of all the cases of epidermolysis bullosa reported up to that date and added 3 cases of his own. He
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