3/0 USES OF THE LIVER DUCTLESS GLANDS 



centage of cholesterin over the blood of the hepatic veins, while the 

 percentage in the arterial blood is large. The arterial blood is the 

 mixed blood of the entire system ; and as it probably passes through no 

 organ which diminishes its cholesterin before it goes to the liver, it con- 

 tains a quantity of this substance which must be removed. The portal 

 blood, coming from a limited part of the system, contains less choles- 

 terin, although it gives up a certain quantity. In the circulation in the 

 liver, the portal system largely predominates and is necessary to other 

 important actions of this organ, such as the production of glycogen ; 

 but soon after the portal vein enters the liver, its blood becomes mixed 

 with that from the hepatic artery, and from this mixture the cholesterin 

 is separated. It is necessary only that blood containing a certain quan- 

 tity of cholesterin, should come in contact with the bile-secreting cells in 

 order that this substance shall be separated. The fact that it is elimi- 

 nated by the liver is proved with much less difficulty than that it is formed 

 in the nervous system. In fact, its presence in the^bile, and the neces- 

 sity of its constant removal from the blood, consequent on its constant 

 formation and absorption, are almost sufficient in themselves to warrant 

 the conclusion that it is eliminated by the liver. 



In treating of the composition of the feces, the changes which the 

 cholesterin of the bile undergoes in its passages down the intestinal 

 canal have been fully considered. But one examination only was made 

 of the quantity of stercorin contained in the daily fecal evacuation ; and 

 assuming that the quantity of cholesterin excreted by the liver is equal 

 to the stercorin found in the evacuations, the quantity in twenty-four 

 hours is about ten and a half grains (0.68 gram). This corresponds with 

 he estimates of the daily quantity of cholesterin excreted, calculated 

 from its proportion in the bile and the estimated daily quantity of bile 

 produced by the liver. 



To complete the chain of the evidence leading to the conclusion that 

 cholesterin is an excrementitious product formed in certain of the tis- 

 sues and eliminated by the liver, it is necessary only to show that it 

 may accumulate in the blood when the eliminating action of the liver is 

 interrupted. 



In a case of simple jaundice from duodenitis, in which there was no 

 great disturbance of the system, a specimen of blood taken from the 

 arm presented evidences of the coloring matter of the bile, but the 

 proportion of cholesterin was not increased, being only 0.508 of a part 

 per thousand. The feces contained a large proportion of saponifiable 

 fat but no cholesterin or stercorin. 



In a case of cirrhosis with jaundice, there was ascites, with great 

 general prostration. This patient died a few days after the blood and 



