292 EXCRETION. 



only for the biliary salts. 1 "We have not been able to re- 

 peat these experiments on frogs, and analyze the blood for 

 cholesterine, but we have arrived at very positive results 

 in the study of the blood in diseased conditions of the 

 liver, that are interesting alike to the physiologist and the 

 pathologist. 



It has long been recognized that cases of ordinary ictei as 

 are not of a grave character, while there are cases in which 

 the jaundice, though less marked as regards color, is a very 

 different condition. Chemists have analyzed the blood, in 

 the hope of explaining this difference by the presence, in the 

 grave cases, of the taurocholate and glycocholate of soda; 

 but their failure to detect these principles leaves the ques- 

 tion still uncertain. The real distinction, arguing from 

 purely theoretical considerations, would lie in the propo- 

 sition that, in cases of simple jaundice, there is merely a 

 resorption from the biliary passages of the coloring matter 

 of the bile, and in grave cases which are almost invaria- 

 bly fatal there is retention of cholesterine in the blood. 



We have not been able, on account of the insolubility of 

 cholesterine, to observe the effects of injecting it into the 

 blood-vessels, but we have had an opportunity of making an 

 examination of the blood of a patient in the last stages of 

 cirrhosis of the liver, accompanied with jaundice, and com- 

 pared it with an examination of the blood of a patient suffer- 

 ing from simple icterus. Both of these patients had decolo- 

 ration of the faeces ; but in the first the icterus was a grave 

 symptom, accompanying the last stages of disorganization 

 of the liver ; while in the latter it was simply dependent on 

 duodenitis, and the prognosis was favorable and verified by 

 the result. As icterus accompanying jaundice is of very in- 

 frequent occurrence, we were fortunate in having an oppor- 

 tunity of comparing the two cases. 



Without giving in full the details of these cases and the 

 examinations, which are contained in our original memoir 



1 See p. 267. 



