74 BILE. 



The residue of the bile insoluble in absolute alcohol must now 

 be determined with the view of checking the analysis ; it con- 

 tains pigment, partly free and partly in combination with lime, 

 alkaline and earthy phosphates, with a little alkaline carbonate 

 and chloride of sodium, very rarely sulphate of potash, but often 

 a little taurine ; its amount is generally so small that any further 

 quantitative determination, as, for instance, by means of diluted 

 spirit, water, acids, &c., is hardly practicable. 



Those who have studied all that has been stated in the first 

 volume regarding these substances and their properties, need 

 hardly be informed that the methods of analysing the bile can, and 

 indeed must, be variously modified, and that the method we have 

 just given can only serve the purpose of an illustrative scheme. 



We have stated in the first volume all that is necessary regard- 

 ing the quantitative determination of the cholesterin and fatty 

 acids. These substances can only be determined quantitatively 

 when a very large quantity of bile is submitted to analysis. 



Biliary concretions must be ranked amongst the morbid pro- 

 ducts of the secretion of the liver. Few points in pathological 

 chemistry, in the earlier period of that science, have received so 

 much attention as gall-stones ; but all the very numerous obser- 

 vations which have been made regarding them are reducible to 

 the following facts : these concretions occur principally in the 

 gall-bladder, more rarely in the biliary ducts; in women more 

 frequently than in men, and especially in aged persons : they 

 often co-exist with cancer of the liver or of other organs, but it 

 cannot be positively affirmed that carcinoma is a predisposing 

 cause of gall-stones, since both these adventitious products 

 specially pertain to advanced age and to the female sex : each is, 

 however, often found independently of the other. Gall-stones 

 appear to be of more common occurrence in England, Hanover, 

 and Hungary, than in other countries. Most gall-stones are so 

 rich in cholesterin, that the other constituents are of very secondary 

 importance ; all, however, contain one or more nuclei, consisting 

 of traces of mucus and earthy phosphates, but principally of an 

 insoluble combination of lime with bile-pigment : a large number 

 of gall-stones are formed of a mixture of cholesterin and pigment- 

 lime /* the latter is sometimes uniformly distributed through the 

 concretion, in other cases we observe alternating layers of choles- 



* [Pigmentkalk in the German j it is the compound noticed in page 65. 



0. . J).] 



