ii EXTERNAL DIGESTIVE SECRETIONS 147 



(c) Secretion of bile ceases in cases of fatty degeneration of the 

 liver, yet there is no jaundice. Frerichs cites a clinical case in 

 which no bile salts were found in the urine. But Baldi, on 

 poisoning dogs with a fistula of the gall-bladder by small doses 

 of phosphorus which produced fatty degeneration of the liver, 

 observed that bile still flowed from the liver up to a few days 

 before the death of the animal. When, owing to catarrh of the 

 bile-ducts, the flow from the fistula ceased, bile salts were found 

 to be present in the urine. He noted, moreover, that after long 

 abstinence the hepatic cells of frogs became atrophied, while the 

 gall-bladder swelled, owing to the enormous accumulation of bile, 

 till it equalled or exceeded the volume of the liver. He further 

 observed that transfusion of ox-blood into dogs with fistula of the 

 gall-bladder not only increased the flow of bile freely given off by 

 the fistula, but caused the passage into the urine of bile acids and 

 pigments. From this it is legitimate to conclude that bile is not 

 an exclusively hepatic formation, and that the heterogeneous blood 

 transfused gives rise by decomposition of haemoglobin (as held by 

 Landois) to the bile pigments, and may possibly, by decomposition 

 of protein, account for the formation of bile acids. 



(d) It is impossible, either during abstinence or in digestion, 

 to demonstrate the presence of bile constituents in normal hepatic 

 tissue by micro-chemical means. The varying aspect of the hepatic 

 cells in these two periods (which we shall study elsewhere) seems 

 to be exclusively connected with the formation of glycogen (Cl. 

 Bernard), and not with the formation of bile. This fact seems 

 to favour the ancient doctrine of the diffuse formation of bile, 

 rather than the theory which regards it as the exclusive secretion 

 of the liver cells. 



None of these data, as can be seen, gives a decisive answer in 

 regard to the exclusively hepatic origin of the specific products of 

 bile. Other more recent work, however, leaves no doubt as to 

 this point. We may summarise the most cogent and conclusive 

 arguments : 



(a) If bile, like urine, were the excretory product of different 

 tissues, its nitrogen and sulphur content would vary in proportion 

 to the total protein consumption of the body. Kunkel (1870) 

 and Spiro (1880), on the contrary, show on dogs with fistula of the 

 gall-bladder that only a small part of the nitrogen and sulphur 

 from the proteins of the food are eliminated with the bile, and 

 that this quantity does not increase proportionately with the 

 amount of protein ingested. When the amount of protein intro- 

 duced as food is increased eight times, the amount of nitrogen 

 and sulphur in the bile is only doubled. Barbera (1896) showed 

 that this increase of nitrogen in the bile is also seen after the 

 ingestion of fats. It does not therefore depend on the greater 

 quantity of nitrogen circulating in the blood, but solely on the 



