70 BILE. 



without any change of colour. I obtained it, like Bizio, by dilut- 

 ing the bile with water ; the insoluble portion was boiled with water, 

 upon which a fatty green mass separated on the surface, which 

 had the above-named properties in common with erythrogen. 



In the bile of a child who died suddenly, I * found a consider- 

 able quantity of sulphide of ammonium. 



It is sufficiently obvious that this sulphide of ammonium had not 

 been separated from the blood by the liver ; the only singularity is, 

 that it should have been found in such large quantity in the bile, 

 when the examination was made sixteen hours after death. Un- 

 fortunately nothing was known of the previous history of the 

 case. 



With the exception of the above-mentioned changes, the only 

 other alterations in morbid bile (which can obviously only be 

 obtained from the body after death), are of a quantitative nature 

 in reference to the individual constituents, or are represented by 

 modifications of the pigment. The bile has been found to be poor 

 in solid constituents in persons who have died from severe inflam- 

 matory affections, especially from pneumonia, and likewise in fatal 

 cases of dropsy ; it is even more aqueous and attenuated in certain 

 cases of typhus; and in diabetes there is always an excess of 

 water. In tuberculosis the bile is very frequently, although not 

 invariably, poor in solid constituents. 



In cases of tuberculosis, Gorup-Besanez usually found the bile 

 of the ordinary consistence ; but Frerichs always found it attenu- 

 ated, unless when the tuberculosis was complicated with fatty 

 liver. This difference may be readily accounted for; Frerichs 

 probably analysed bile in cases in which an anaemic condition had 

 been induced, in consequence of abundant effusion (as, for instance, 

 where diarrhoea had been excited by intestinal ulceration, or 

 where there had been pleural or peritoneal dropsy ; his last 

 case was one of obsolete tubercle). Again, no one who has 

 examined the blood of tuberculous patients before and after the 

 exudation has been thrown off, can wonder that the bile should pre- 

 sent a thin liquid appearance after an attack of acute tuberculosis. 

 In tuberculosis combined with fatty liver, Frerichs, like Gorup- 

 Besanez, found the bile dense, since in this condition the blood is 

 less poor in solid constituents, and the hepatic affection is itself 

 opposed to a copious secretion of dilute bile. Both chemists 

 found the bile very diluted and scanty in typhus; the bodies 

 from which the bile was obtained, were those of persons in whom 

 * Schmidt's Jahrbiicher der ges. Med. Bd. 25, S. 16. 





