370 ' HYDROPS CYSTIDIS FELLED,' [BOOK II. 



secretion. The average quantity of fluid secreted in 24 hours was 

 found to be 71*3 c.c. The following are the results of the observa- 

 tions made on April 29, 1884. 



Volume of secretion in 24 hours 72 c.c. 

 Sp. gr. 1009-5 



Reaction. Alkaline. 



Solid matters in 1000 parts 15'36 

 Water . . 984'64 



Organic matters, chiefly mucin, in 1000 parts 6*72 



Chlorides equal to Nad 5'73 



Sodium carbonate 2'20 



Other salts, containing phosphates, potassium salts, &c. 0'7l 



In accordance with the opinion already expressed, it appears, 

 however, to the Author, that we cannot from the study of the above 

 and similar cases form any accurate idea of the secretion of the 

 normal gall-bladder. The above analysis represents the characters 

 of the liquid found in typical cases of hydrops cystidis fellece and was 

 probably the product of a mucous membrane of which the secreting 

 epithelium no longer possessed its normal characters. 



Empyema of As a result of an infective cholecystitis, empyema 

 the gall-Wad- of the gall-bladder has been observed, i.e. the gall- 

 der - bladder becomes distended with a purulent fluid. 



Naunyn, who has investigated such cases, has found the purulent 

 fluid to contain Bacterium coli commune 1 . 



SECT. 3. THE INFLUENCE OF DRUGS ON THE SECRETION OF 

 BILE. CHOLAGOGUES. 



In discussing the action of so-called icterogenic poisonous agents, 

 we incidentally pointed out that they appear to lead, in the first 

 instance, to an increase of the quantity of bile secreted, to a true 

 polycholia. We have now to refer briefly to researches which have 

 been made with the view of determining whether medicinal agents 

 exist which exert a direct action on the secretion of bile, especially 

 whether drugs exist which may correctly be termed hepatic stimu- 

 lants or cholagogues. The fact that certain drugs when administered 

 to man induce copious bilious stools has, from time immemorial, been 

 supposed to indicate that they possess a truly cholagogue action, but 

 the conclusion is one which cannot logically be drawn from the 

 premises. 



"The clinical observer," says Professor Rutherford, to whose 

 researches we owe the greater part of our knowledge on this subject, 

 "has supplied most valuable information regarding the power of 



1 B. Naunyn, 'Die infectiose Cholecystitis und das Empyem der Gallenblase,' Klinik 

 d. Clwlelithiasis, p. 105. 



