ACTION OF THE BILE IN DIGESTION. 283 



which the bile has been completely shut off from the intestine and discharged externally 

 by a fistula into the gall-bladder. As far as could be ascertained, this animal, from the 

 first, presented no disturbances which were not due solely to the absence of the bile from 

 the intestine and its discharge externally. Although the phenomena here presented do 

 not teach us much that is definite concerning the digestive action of the bile, taken in 

 connection with what has been ascertained concerning the general properties of this se- 

 cretion, they throw some light upon its functions. 



One of the functions which has been ascribed to the bile is that of regulating the peris- 

 taltic movements of the small intestine and of preventing putrefactive changes in the 

 intestinal contents and the abnormal development of gas. Experiments on this point are 

 somewhat conflicting. Our own observations would lead us to doubt the constant influ- 

 ence of the bile upon the peristaltic movements. During the first few days of our experi- 

 ment, the dejections were very rare ; but they afterward became regular, and, at one 

 time, even, there was a tendency to diarrhoea. There can be no doubt, however, that 

 the bile retards the putrefaction of the contents of the intestinal canal, particularly when 

 animal food has been taken. The faeces in the dog were always extremely offensive. 

 Bidder and Schmidt found this to be the case in dogs fed entirely on meat ; but the faeces 

 were nearly odorless when the animals were fed on bread alone. In the case of intes- 

 tinal fistula in the human subject, the evacuations which took place after the intro- 

 duction of alimentary substances into the lower portion of the intestine had an unnaturally 

 offensive and putrid odor. In this case, as it was impossible for matters to pass from the 

 portions of the intestine above the fistula to those below, the food introduced into the 

 lower opening was completely removed from the action of the bile. 



As far as the digestion of the different alimentary principles is concerned, it has been 

 shown that the bile, of itself, has no particular action upon any of them. In the faeces 

 of animals with biliary fistula, the only peculiarity which has been observed, aside from 

 the putrefactive odor and the absence of the coloring matter of the bile, has been the 

 presence of an abnormal proportion of fat. "We have observed this in the faeces of a pa- 

 tient suffering under jaundice apparently due to temporary obstruction of the bile-duct. 

 This fact was noted in the dogs experimented upon by Bidder and Schmidt. 



The various experiments which have been performed upon animals render it almost 

 certain that the bile has an important influence, either upon the digestion or upon the ab- 

 sorption of fats. Bidder and Schmidt noted in animals with biliary fistula that the chyle 

 contained very much less fat than in health. In an animal with a fistula and the bile-duct 

 obliterated, the proportion of fat was 1'90 parts to 1,000 parts of chyle ; while, in an ani- 

 mal with the biliary passages intact, the proportion was 32*79 parts per 1,000. In ani- 

 mals operated upon in this way, there is frequently a great distaste for fatty articles of 

 food. In our own observation, the dog refused fat meat, even when very hungry and 

 when lean meat was taken with great avidity. 



Experiments concerning the influence of the bile upon the absorption of fats have re- 

 sulted in hardly any thing definite. We know only the fact that, when the bile is diverted 

 from the intestine, the proportion of fat in the chyle is greatly reduced, and a large pro- 

 portion of the fat taken with the food passes through the intestine and is found in the 

 faeces. 



The action of the bile in exciting muscular contraction, particularly in the smooth 

 muscular fibres, is pretty well established. It has been shown by Schiff that this fluid 

 acts upon the muscular fibres situated in the substance of the intestinal villi, causing 

 them to contract, and, according to his view, assisting in the absorption of chyle by emp- 

 tying the lacteals of the villi. The whole subject, however, of the absorption of fats is 

 exceedingly difficult of investigation ; and our knowledge of it has not been sensibly ad- 

 vanced by the experiments upon the influence exerted by the bile. Notwithstanding the 

 obscurity in which this subject is involved, it is certain that the progressive emaciation, 

 loss of strength, and final death of animals deprived of the action of the bile in the intes- 



