EXCRETORY FUNCTION OF THE LIVER. 293 



on cholesterine, 1 it is sufficient here to state the main results 

 of the examinations of the blood and faeces. 



In the case of simple jaundice from duodenitis, in which 

 there was no great disturbance of the system, a specimen of 

 blood, taken from the arm, presented undoubted evidences 

 of the coloring matter of the bile, but the proportion of 

 cholesterine was not increased, being only 0*508 of a part 

 per thousand. The faeces contained a large proportion of 

 saponifiable fat, but no cholesterine or stercorine. 



In the case of cirrhosis with jaundice, there were ascites 

 and great general prostration. This patient died a few days 

 after the blood and faeces had been examined, and the liver 

 was found in a condition of cirrhosis, with the liver-cells 

 shrunken, and the gall-bladder contracted. In this case the 

 blood contained 1*850 pts. of cholesterine per thousand, more 

 than double the largest quantity we had ever found in health. 

 The faeces contained a small quantity of stercorine. 



Inasmuch as cases frequently present themselves in which 

 there are evidences of cirrhosis of the liver, with little, if 

 any, constitutional disturbance, while others are attended 

 with grave nervous symptoms, it seemed an interesting ques- 

 tion to determine whether it be possible for cholesterine to 

 accumulate in the blood without the ordinary evidence of 

 jaundice. WQ had an opportunity of examining the blood 

 in two strongly-contrasted cases of cirrhosis, in neither of 

 which was there jaundice. 



One of these patients had been tapped repeatedly (about 

 thirty times), but the ascites was the only troublesome symp- 

 tom, and his general health was pretty good. In this case 

 the proportion of cholesterine in the blood was only 0*246 of 

 a part per thousand, considerably below the quantity that we 

 had found in health. 



The other patient had cirrhosis, but was confined to the 

 bed and was very feeble. The proportion of cholesterine in 



1 American Journal of the Medical Sciences, Philadelphia, 1862, New Series, 

 vol. xliv., p. 349, et seq. 



