414 THE LIVER. 



tions, with abundance of codfish and then found so much glycogen (6.46 

 per cent in the liver and 1 per cent in the muscle) that a re-formation of 

 glycogen must have undoubtedly occurred. By special control exper- 

 iments with fat feeding they also showed that the glycogen did not orig- 

 inate from the fat but must unquestionably have come from the protein. 

 Carbohydrates and proteins are without question true glycogen-formers, 

 while the question in regard to fats is still open. 



The Bile and Its Formation. 



By the establishment of a biliary fistula, an operation which was 

 first performed by SCHWANN in 1844 and which has been improved lately 

 by DASTBE and PAWLOW/ it is possible to study the secretion of the bile. 

 This secretion is continuous, but with varying intensity. It takes 

 place under a very low pressure; therefore an apparently unimportant 

 hindrance in the outflow of the bile, namely, a stoppage of mucus in the 

 exit, or the secretion of large quantities of viscous bile, may cause stagna- 

 tion and absorption of the bile by means of the lymphatic vessels (absorp- 

 tion icterus). 



The quantity of bile secreted in the twenty-four hours in dogs can be 

 exactly determined. The quantity secreted by different animals varies, 

 and the limits are 2.9-36.4 grams of bile per kilo of weight in the twenty- 

 four hours. 2 



The reports as to the extent of bile secretion in man are few and 

 not to be depended on. NOEL-PAYTON, MAYO-ROBSON, HAMMARSTEN, 

 PFAFF and BALCH, and BRAND 3 found a variation between 514 and 

 1083 cc. per twenty-four hours. Such determinations are of doubtful 

 value, because in most cases it follows from the composition of the 

 collected bile that the fluid is not the result of a secretion of normal liver 

 bile. 



The quantity of bile secreted is, however, as shown by STADEL- 

 MANN, 4 subject to such great variation, even under physiological con- 

 ditions, that the study of 'those circumstances which influence the secre- 

 tion is very difficult and uncertain. The contradictory statements 

 by different investigators may probably be explained by this fact. 



^chwann, Arch. f. (Anat. u.) Physiol., 1844; Dastre. Arch, de Physiol. (5) 2; 

 Pawlow, Ergebnisse der Physiol., 1, Abt. 1. 



2 In regard to the quantity of bile secreted in animals see Heidenhain, Die Gallenab- 

 sonderung, in Hermann's Handbuch der Physiol., 5, and Stadelmann, Der Icterus und 

 seine verschiedenen Formen (Stuttgart, 1891). 



3 Noel-Payton, Rep. Lab. Roy. Coll. Edinburgh, 3; Mayo-Robson, Proc. Roy. Soc., 

 47; Hammarsten, Nova Act. Reg. Soc. Scient. Upsala (3), 16; Pfaff and Balch, Journ. 

 of Exp. Med., 1S97; Brand, Pfliiger's Arch., 90. 



4 Stadelmann, Der Icterus, etc., Stuttgart, 1891. 



