USE OF TEE BILE IN INTESTINAL DIGESTION. 175 



gastric juice and bile, a strong ammoniacal odor resulting from decomposi- 

 tion was emitted from the former, whilst the latter was pure and free from 

 any smell whatever. And it was remarked by MM. Tiedemann and (rineliii 

 (and also recently by Hoffmann), that when the bile was prevented from 

 passing into the alimentary eanal, the contents of the latter were more fetid 

 than usual. Moreover, it is found that the admixture of bile with ferment- 

 ing substances checks the process of fermentation ; and M. Bernard 1 has 

 shown by ingeniously-contrived experiments, that this power is exerted also 

 to some "extent in the living body. Hence we can understand how the re- 

 flux of bile into the stomach should seriously interfere with the process of 

 gastric digestion ; and how, when there is a deficient secretion of bile, or 

 more food is swallowed than the bile provided for it can act upon, or the 

 character of the biliary secretion itself has undergone any serious perver- 

 sion, there should be much more than the normal amount of putrefactive 

 fermentation, as is indicated by an evolution of flatus, and very frequently 

 by diarrhoea. Bchiff 2 and Budge 3 have shown that the bile produces ener- 

 getic, and indeed almost tetanic spasms of the muscles, both voluntary and 

 involuntary, when applied either to the tissue itself or to the nerves supply- 

 ing it. Its importance, therefore, in maintaining the peristaltic action of 

 the intestine is probably considerable, whilst by exciting the involuntary 

 muscular fibre-cells of the villi it very probably materially aids the move- 

 ment of the chyle in the lacteals. Moreover, the presence of a proper 

 quantity of bile in the intestine seems to promote the secreting action of the 

 intestinal glandulte: this appears from the tendency to constipation which 

 is usually consequent upon deficiency of the secretion, and from the diar- 

 rhoea which proceeds from its excess; and is confirmed by the purgative 

 properties which inspissated ox-gall has been found to possess. Notwith- 

 standing all its uses, however, it must be admitted that the prevention of 

 the discharge of bile into the alimentary canal is not attended with the 

 deleterious results which might have been anticipated from it ; for it has 

 been found by the experiments of Schwann, Blondlot. and Bernard, that if 

 the bile-duct be divided, and a tube be inserted in it in such a manner as 

 to convey away the secretion through a fistulous orifice in the abdominal 

 parietes, the animals thus treated may live for weeks, months, or even years, 4 

 although they usually die at last with signs of inanition. 



125. The best evidence that has hitherto been obtained of the quantity of 

 Bile daily poured into the alimentary canal of man has been afforded by 

 patients suffering from fistula of the cystic, or of the common bile-duct. In 

 one of these cases which was under the observation of v. Wittich 5 the quan- 

 tity discharged amounted to 22.2 c.c. per hour, or 532.8 c.c., which are 

 equivalent to one pint, in 24 hours. In another case observed by Westpha- 

 len 6 a man weighing about 140 Ibs. discharged almost exactly the same 

 quantity (7703 grains = 1 Ib. 703 gr. av., or about one pint) with but 

 small variation daily for 10 days. Nasse and Plattner 7 obtained from a dog 

 105 grains, and Stackmaun 108 grains per diem for every 1 Ib. of body weight. 

 Bidder and Schmidt, from experiments on a dog, estimated the quantity in 



1 Amor. Journ. of Mod. Sci., Oct. 1851, p. 351. 



2 Archiv fur Phys. Heilk., B. ix, p. 60. 



3 Physiologie, p. 195, 1861. 



4 At/the meeting of the French Academy, June 23d, 1851, M Blondlot gave the 

 history and an account of the post-mortem examination of a dog that had lived five 

 years without the passage of any bile into the intestinal tube. For effects of Liga- 

 ture of Bile-ducts see Legg, St" Earth. Hosp. Rep., vol. ix, 1873, p. 161. 



5 Pfliiger's Archiv, B. vi, 1872, p 181. 



6 Deuts. Archiv. f. klin. Med., 1873, B. xi, p. 588. 



7 Beclard's Physiologie, 1862, p. 501. 



