MORBID BILE. 71 



the morbid process was already localised, or when death was in- 

 duced, as it frequently is, not directly by the typhus, but by the 

 subsequent anaemia. In two cases of typhus, in which the plaques 

 in the intestine were only just recognizable, I found the bile 

 dense ; and every pathological anatomist must recollect cases in 

 which the bile was tough and consistent, and, therefore, rich in 

 solid constituents in persons who had died from typhus. In every 

 case Frerichs found from 93 to 96^ of water in the bile, and Gorup- 

 Besanez for the most part a somewhat smaller quantity. 



The solid constituents are commonly increased in those abdo- 

 minal diseases in which the motion of the blood in the larger veins 

 is impeded, and where, as in certain cases of heart-disease, the 

 blood accumulates in excessive quantity in the portal vein and the 

 hepatic vessels. The motion of the blood in the hepatic capil- 

 laries is (as we know from physiological researches) so torpid, that if 

 there be any impediment, as, for instance, disease of the heart, to 

 the passage of the blood in the vena cava, and any check to the 

 escape of the blood from the liver through the hepatic veins, an 

 almost entire stagnation of the blood-current in the liver must 

 ensue. 



In cholera we also find the bile dense, tough, and consistent ; 

 this condition is likewise due for the most part to mechanical con- 

 ditions ; the blood of cholera patients is so tenacious and thick, 

 that even in the vicinity of the heart it moves slowly, and thus 

 causes a disturbed state of the circulation generally; and this 

 effect is the more striking in the hepatic circulation, when, more- 

 over, in consequence of the blood being deficient in water, a less 

 aqueous bile must be secreted. 



The mucus is often relatively increased when the bile is very 

 dilute ; indeed, in typhus we sometimes find little else in the gall- 

 bladder than mucus, the resinous constituents being almost 

 entirely or altogether absent ; and .the same is observed in catarrh 

 of the biliary ducts. 



In the absence of quantitative determinations, we cannot 

 decide whether the separation of crystals of cholesterin, which we 

 can sometimes observe with the microscope in morbid bile, is 

 associated with an absolute augmentation of this lipoid. Gorup- 

 Besanez has only occasionally observed this phenomenon in very 

 concentrated bile. 



Free fat is always present in the bile, but is held in solution by 

 the taurocholic acid ; occasionally, however, in examining morbid 

 bile by means of the microscope, we may detect fat-globules, which 



