ITS FORMATION. 85 



liver through the lymphatics or from the intestinal canal; but 

 owing to the uncertainty of Pettenkofer's bile-test, our conclusions 

 regarding the presence of the biliary resinous acids must be wholly 

 subjective. The lymphatics undoubtedly play a highly important 

 part in the resorption of the bile, and these vessels are moreover 

 alone able to absorb bile from the liver, as the venous plexuses of 

 the hepatic artery open into the portal vein, and would therefore 

 convey the recently absorbed bile back to the hepatic cells. In 

 the dead body the bile readily infiltrates into the neighbouring 

 parts, but in living animals such is not the case ; it is probable, 

 however, that we might also observe a similar imbibition of bile 

 during life if it were not directly absorbed by the lymphatics 

 surrounding and intersecting the surface of the liver as well as the 

 biliary ducts and the gall-bladder. It is believed that many sub- 

 stances undergo chemical changes in the lymphatics ; but it is not 

 known whether bile-pigment and the biliary acids are carried 

 unchanged through the healthy lymphatic system, or whether they 

 experience any alterations in it. We do not know, therefore, 

 whether or riot the lymphatics perform their function in those 

 diseases in which icterus is present without any obvious organic 

 changes in the liver, or where, in addition to the jaundice, a large 

 quantity of bile passes into the intestine. It would appear from 

 experiments of injecting filtered bile into the veins, that the blood 

 possesses the property, when in a normal state, of exerting a 

 metamorphic action on the biliary matters ; yet life may be prolonged 

 for years after the complete occlusion of the ductus choledochus. 

 We are, however, ignorant whether the blood in febrile and inflam- 

 matory conditions where its oxidation is considerably diminished 

 loses the capacity for metamorphosing these biliary matters like 

 the extractive matters, uric acid, cystine, &c. Why does icterus 

 occur in fatty liver only when acute diseases supervene? In 

 granular liver many of the small biliary ducts may be obliterated, 

 and the hepatic granules consequently filled with bile, and yet 

 icterus may not have been manifested during life. Acute yellow- 

 atrophy of the liver is a disease that has been but seldom observed, 

 and still less investigated (excepting by Rokitansky) ; of the che- 

 mical metamorphoses by which it is attended we know nothing. 

 We do not think, therefore, that the meagre observations hitherto 

 made by the bedside and in the dead-house justify us in drawing 

 conclusions regarding the formation of bile in the blood, and the 

 occurrence of icterus from the suppression of the biliary secretion. 

 If the view that the formation of bile takes place in the liver 



