364 KKKKCTS OF DRUGS ON THE SECRETION OF BILE. 



same occurs when they are injected into the blood, but in this case, the stage of 

 excitement is very short. The phenomenon is not affected by section of the vagi. 

 It is probable, that when the action of the bile salts is long continued they act 

 upon the heart-muscle (Traube). In addition to the action on the heart, there is 

 slowing of the. respiration and diminution of temperature. 



(5). That the nervous system, and perhaps also the muscles, are affected, either by 

 the bile salts or by the accumulation of cholesterin in the blood (Flint, K. Miiller), 

 is shown by the very general relaxation, sensation of fatigue, weakness and 

 drowsiness, lastly deep coma sometimes there is sleeplessness, itchiness of the 

 skin, even mania, and spasms. Lciwit, after injecting bile into animals, observed 

 phenomena referable to stimulation of the respiratory, cardio-inhibitory, and vaso- 

 motor nerve-centres. 



(6.) In very pronounced jaundice, there may be " yellow vision'" (Lucretius 

 Carus), owing to impregnation of the retiua and macula lutca with the bile pig- 

 ment. 



(7.) The bile acids in the blood dissolve the red blood-corpuscles. The haemo- 

 globin is changed into new bile pigment, and the globulin-like body of the 

 haemoglobin may form urinary cylinders or casts in the urinary tubules 

 (Nothnagel), which are ultimately washed out of the tubules by the urine. 



Passage Of substances into the Bile. Various substances pass into the 

 bile, such substances being in the blood, viz., the metals (v. Sartoris, Mohnheim, 

 Orfila) copper, lead, zinc, nickel, silver, bismuth (Wichert), arsenic, antimony, 

 iron ; these substances are also deposited in the hepatic tissues. Potassium iodide, 

 bromide, and sulphocyanide (Peiper), and turpentine also pass into the bile, and, to 

 a less degree, cane-sugar and grape-sugar (Mosler) ; sodium salicylate, and carbolic 

 acid (Peiper). If a large amount of water be injected into the blood, the bile 

 becomes albuminous (Mosler); mercuric and mercurous chlorides cause an increase 

 of the water of the bile (G. Scott). Sugar has been found in the bile in diabetes ; 

 leucin and tyrosin in typhus, lactic acid and albumin in other pathological 

 conditions of this fluid. 



[Influence of Drugs on the Secretion of Bile. Two methods are adopted, 



one by means of permanent fistula?, and the other by establishing temporary 

 h'stulae. The latter is the more satisfactory method, and the experiments are 

 usually made on fasting curarised dogs. A suitable cannula is introduced into the 

 common bile-duct, as described at p. 361, the animal is curarised, artificial 

 respiration being kept up, while the drug is injected into the stomach or intestine. 

 Rohrig iised this method, which was improved by Rutherford and Vignal. Rb'hrig 

 found that some purgatives, croton oil, colocynth, jalap, aloes, rhubarb, senna, 

 and other substances, increased the secretion of bile. Rutherford and Vignal 

 investigated the action of a large number of drugs on the bile-secreting mechanism. 

 They found that croton oil is a feeble hepatic stimulant, while podophyllin, aloes, 

 colchiciim, euonymin, iridin, sanguinarin, ipecacuan, colocynth, sodium phosphate, 

 phytolaccin, sodium benzoate, sodium salicylate, dilute nitrohydrochloric acid, 

 ammonium phosphate, mercuric chloride (corrosive sublimate), are all powerful, or 

 very considerable, hepatic stimulants. They found that some substances stimulate 

 the intestinal glands, but not the liver, e.g., magnesium sulphate, castor oil, 

 gamboge, ammonium chloride, manganese sulphate, calomel. Other substances 

 stimulate the liver as well as the intestinal glands, although not to the same extent, 

 e.g., scammony (powerful intestinal, feeble hepatic stimulant) ; colocynth excites 

 both powerfully; jalap, sodium sulphate, baptisin, act with considerable power 

 both on the liver and the intestinal glands. Calabar bean stimulates the liver, and 

 the increased secretion caused thereby may be reduced by sulphate of atropin, 

 although the latter drug, when given alone, does not notably affect the secretion 

 of bile. The injection of water or bile slightly increases the secretion. In all 

 cases where purgation was produced by purely intestinal stimulants, such as 



