[Reprinted jrom the Journal of Physiology, 

 Vol. XXXV. Nos. 1 & 2, December 29, 1906.] 



OBSERVATIONS ON HUMAN CHYLE. BY J. MOLYNEUX 

 HAMILL, M.A., M.B. (Cantab.), B.Sc. (Lond.), Sharpey Scholar. 



(From the Physiological Laboratory of University College, London.) 



THE difficulty of establishing and keeping permanent a chylous fistula 

 in animals has been a formidable barrier to the experimental investiga- 

 tion of the chyle flow. Further, the small amount of chyle which can 

 be obtained from animals and the difficulty of collecting it place 

 additional obstacles in the way of accurate work. For these reasons the 

 rare cases of chylous fistula or, if I may suggest the term, chylorrhcea, 

 which have been described from time to time as occurring in man, afford 

 a favourable opportunity both for the examination and analysis of the 

 chyle and for the solution of problems relating to the absorption and 

 utilisation of ingested fats and allied substances. 



Accounts of the chyle of man varying in degree and detail have 

 been given by Johannes Miiller (24) , Marchand and Colberg (21) , 

 Hensen (18) , Gubler and Quevenne' 11 ', and Munk and Rosenstein (Z6) . 

 The chyle in these cases was obtained from a fistulous opening, the 

 work of the last two investigators being the best and most exhaustive of 

 any which has yet appeared upon the subject. There are also accounts 

 of chylous ascites by Quincke (30) , Whitla (38) , I. Strauss (37) , Hase- 

 broek (13) , and Minkowski 123 ', and of chylous urine by Erben (8) , 

 Chabrie (6 ',Brieger (3 >, Grimm' 9 ', and Carter* 5 '. Cases in which chyle, 

 obtained from the cut thoracic duct, has been investigated are 

 described by Rees< 31 >, Patonf 29 ', Carlier< 4 >, and H. Strauss* 36 '. 



The observations of the above workers have shown that the general 

 characters of human chyle are the same as those of animals but their 

 observations are incomplete in many points and it was desirable to take 

 any opportunity that offered of making a detailed examination under 

 varying conditions. Such an opportunity was afforded to me by the 

 kindness of Mr Barker who had under his care in University College 

 Hospital a patient with a chylous fistula. 



The patient was a well developed man, aged 20, weight 140 Ibs. 

 Except for the abnormality immediately to be described he enjoyed 

 PH. xxxv. 10 



