280 



THE SO-CALLED ' CIRCULATION OF BILE/ [BOOK II. 



ligatured. In these cases, however, he established, in addition, a 

 duodenal fistula. Having, in the first instance, observed a rapid 

 diminution of the quantity of bile flowing from the fistula, he 

 injected into the duodenum the bile which had been secreted by the 

 animal during the previous hour or two hours. After 10, but more 

 obviously after 15, minutes the quantity of bile obtained per fistulam 

 increased and continued to increase during 2, 3, 5 or more successive 

 periods of 10 minutes, according to the quantity of bile injected. 



For the ^second series of experiments, Schiff established his so- 

 called amphibolic biliary fistulas (see page 268). As has been already 

 stated, such fistulas, according to Schiff, enable the experimenter, at 

 will, to divert the whole quantity of bile from the alimentary canal, 

 and at any time to turn it again into its proper channel. Schiff 

 found that the quantity of bile obtained in a given period from such 

 fistulas was always much greater immediately after the bile had been 

 allowed to pass normally into the intestine than when it had been 

 flowing externally. Further, Schiff found that the introduction of 

 solutions of bile-salts into the intestine through a duodenal fistula, 

 caused an increase both in the total quantity of bile and of the bile- 

 solids secreted. Upon these facts, Schiff based a theory that a circu- 

 lation of bile occurs (' Kreislauf der Galle ') : that a portion of the 

 secretion absorbed from the intestine on reaching the liver in the 

 portal blood furnishes the organ with a part of the material for the 

 secretion of fresh bile. Further, finding that the increase of bile 

 secreted followed the introduction of bile into the intestine when the 

 portal vein had been obliterated by the method devised by Ore' of 

 Bordeaux 1 , Schiff concluded that the liver was able not only to 

 utilise, for the purposes of bile-formation, the biliary constituents 

 which reached it in the portal blood, but also those present in the 

 blood of the system. 



The results of numerous observers substantially established the 

 accuracy of the facts recorded by Schiff. Thus Rutherford and 

 Vignal 2 observed that when bile was injected into the intestine the 

 secretion of bile was increased. Tarchanoff 3 after the injection of 

 bilirubin into the blood of a dog with biliary fistula, found that the 

 bile pigment was increased in the bile, and his observations received 

 full confirmation from the researches of Vossius 4 , who determined the 

 bile colouring matters by the method of spectro-photometry. Rosen- 

 kranz in a research conducted under the direction of Kunkel intro- 



1 Ore's method of obliterating the portal vein consists in placing a ligature, as a 

 loop, around the vein, then closing the abdominal wound, taking care that the ends 

 of the loop project through it. By exerting traction on these ends, phlebitis is set up 

 which, in favourable cases, leads to occlusion of the vein. 



2 Kutherford and Vignal, Journal of Anatomy and Physiology, Vol. x. 1876, and 

 xi. 1877. 



3 Tarchanoff, ' Zur Kenntniss der Gallenfarbstoffbildung,' Pfliiger's Archiv, Vol. ix. 

 (1874), p. 329. 



4 Vossius, ' Bestimmungen des Gallenfarbstoffes in der Galle,' Archiv /. exp. 

 Pathol., Vol. xi. (1879), pp. 426454. 



