THE BILE. 223 



the cavity of the intestine by closure of the common bile-duct, and 

 evacuated by a fistula of the gall-bladder, the animals which are the 

 subjects of the operation gradually emaciate, and die with general 

 symptoms of disordered nutrition. 



This experiment has been successfully performed at least ten times by 

 Schwann, Bidder and Schmidt, 1 Bernard, 2 and Prof. A. Flint, Jr., 3 the 

 animals surviving the immediate effects of the operation, the biliary 

 fistula remaining open, and the common bile-duct, as shown by subse- 

 quent post-mortem examination, being permanently closed so that none 

 of the bile could have found its way into the intestine. The general 

 results were alike in these cases. The animals died with the signs of 

 inanition, usually between 30 and 40 days after the operation ; although 

 in one instance death occured at the end of the seventh day, and in 

 another not until the eightieth. The average length of life, in all the 

 cases taken together, was 36 days. The symptoms were constant and 

 progressive emaciation, which proceeded to such a degree that nearly 

 every trace of fat disappeared from the body. The loss of flesh amounted, 

 in one case, to more than two-fifths, and in another to nearly one-half 

 the entire weight of the animal. There was also sometimes a falling off 

 of the hair, and an unusually disagreeable, putrescent odor in the feces 

 and in the breath. Notwithstanding this, the appetite remained good. 

 Digestion was not essentially interfered with, and none of the food was 

 discharged with the feces ; but there was, in the cases of Bidder and 

 Schmidt, much rumbling and gurgling in the intestines, and abundant 

 discharge of flatus, more strongly marked in one instance than in the 

 other. There was no pain ; and death took place, at last, without any 

 violent symptoms, but by a simple and gradual failure of the vital 

 powers. 



It appears therefore that the bile is not simply an excrementitious fluid 

 destined to be eliminated from the system ; but that, after being secreted 

 and discharged by the liver, it must pass into and through the small 

 intestine, in order to maintain the continuous and healthy nutrition of 

 the body. We have already seen, furthermore, that its most essential 

 ingredients, namely, the biliary salts, disappear during their passage 

 through the alimentary canal, and are not to be found in the fecal 

 evacuations. This may be accounted for in two different ways. Either 

 the biliary salts, while in the intestine, may become altered and insolu- 

 ble, so as to lose their reaction with Pettenkofer's test, and be finally 

 evacuated with the feces under this insoluble form; or, on the other 

 hand, they may be reabsorbed from the alimentary canal and thus re-enter 

 the circulation as ingredients of the blood. 



The conclusion generally adopted by physiologists is that they are 

 reabsorbed. The most positive evidence on this point is that derived 



1 Yerdauungssaefte und Stoffwechsel. Leipzig, 1852, p. 103. 



2 Liquides de 1'Organisme. Paris, 1859, torn. ii. p. 199. 



3 Physiology of Man. New York, 1867, p. 369. 



