ACTION OF THE BILE IN DIGESTION. 379 



The important question then to determine was that the bile had been completely shut 

 off from the intestinal canal. An examination of the parts was consequently made in 

 the presence of a number of physicians and students. On the most minute dissection, it 

 was impossible to find any communication between the bile-duct and the duodenum; 

 and the conclusion arrived at was that the animal had lived for five years without a drop 

 of bile passing into the intestine, and, consequently, that this fluid was useless in digestion. 



The facts obtained by all other observers are in direct opposition to the above experi- 

 ment. After a number of trials, we succeeded in establishing a biliary fistula in a dog, 

 the operation being followed by no inflammation of the peritoneum, and, notwithstanding 

 that the animal was voracious and consumed daily large quantities of food, it died in 

 thirty-eight days, of inanition. If our own observation and those of other experimenters 

 be correct, it is impossible that an animal should live in perfect health for years with all 

 the bile discharged by a fistula. 



There is reason to believe that the experiment of Blondlot was inaccurate, and that a 

 communication existed between the bile-duct and the duodenum, which was not discov- 

 ered at the dissection after death. The following observation strengthens us in this 

 opinion : 



We made an attempt on one occasion to ascertain the total amount of bile secreted in 

 twenty-four hours; and, with this view, the ductus communis choledochus was exposed 

 in a dog, the bile contained in the gall-bladder was pressed out, a canula, with an elastic 

 bag attached, was fixed in the duct, and the external wound was closed, leaving the end 

 of the canula, with the bag attached, protruding from the abdomen. The bag ruptured 

 twenty-three hours after, and the experiment was consequently unsuccessful in the end 

 for which it was undertaken. The tube dropped out at the end of forty-eight hours, and 

 the external wound quickly healed. Thirty days after the operation the animal was 

 killed. He had then entirely recovered, and no bile had been discharged externally for 

 a long time. The alvine dejections were perfectly normal, and there could be no doubt 

 that the bile was regularly discharged into the duodenum. On dissection after death, 

 the liver was found normal, and the papilla which marks the opening of the bile-duct 

 into the duodenum was natural in appearance. It was with the greatest difficulty, how- 

 ever, that the communication between the bile-duct and the duodenum could be found ; 

 yet, after patient searching for more than an hour, a small, tortuous tract was discovered. 

 Had it not been certain that bile had been constantly discharged into the intestine, it 

 might have been assumed, even after careful examination, that no such communication 

 existed. This examination convinced us that it was possible that the communication 

 between the duct and the intestine had been reestablished in Blondlot's case, and that it 

 had escaped observation in the dissection after death. 



The isolated experiment of Blondlot does not therefore invalidate the results obtained 

 by Schwann and confirmed by so many eminent physiologists. The bile is not simply an 

 excretion but has an important and essential office to perform in the process of intestinal 

 digestion. We have, however, conclusively shown that, in addition to its recrementitious 

 function, it separates from the blood an important excrementitious principle, cholesterine, 

 which, under a modified form, is discharged in the faeces. This function of the liver will 

 be fully considered under the head of excretion. It is sufficient for our present purposes 

 to show that the bile, unlike any other fluid in the organism, has two distinct functions, 

 dependent upon two distinct classes of constituents. The peculiar principles known as 

 the biliary salts, which are produced in the liver, give to it its digestive properties ; and 

 the cholesterine, which is simply separated from the blood by the liver, gives it its ex- 

 crementitious character. 



As we are much better acquainted with the excrementitious than with the digestive 

 function of the bile, we shall consider, in this connection, only a few of the points con- 

 cerning the chemistry of this fluid, deferring a full account of its composition until we 

 come to treat of it as an excretion. 



