ORIGIN OF CHOLESTERIN 371 



feces had been examined, and the liver was found in a condition of 

 cirrhosis, with the liver-cells shrunken and the gall-bladder contracted. 

 In this case the blood contained 1.85 of a part of cholesterin per thou- 

 sand, more than double the largest quantity found in health. The feces 

 contained a small quantity of stercorin. 



Inasmuch as cases frequently present themselves in which there are 

 evidences of cirrhosis of the liver with little if any constitutional dis- 

 turbance, while others are attended with grave nervous symptoms, it 

 seemed an interesting question to determine whether it were possible 

 for cholesterin to accumulate in the blood without the ordinary evidences 

 of jaundice. An opportunity occurred to examine the blood in two 

 strongly-contrasted cases of cirrhosis, in neither of which was there 

 jaundice. One of these patients had been tapped repeatedly about 

 thirty times but the ascites was the only troublesome symptom and 

 the general health was little impaired. In this case the proportion of 

 cholesterin in the blood was only 0.246 of a part per thousand, consider- 

 ably below the quantity ordinarily found in health. The other patient 

 had cirrhosis, but he was confined to the bed and was very feeble. 

 The proportion of cholesterin in the blood in this case was 0.922 of a 

 part per thousand, a little above the largest proportion found in health. 

 A few other pathological observations of this kind are on record. Picot, 

 in 1872, reported a fatal case of "grave jaundice," in which he deter- 

 mined a great increase in the quantity of cholesterin in the blood, the 

 proportion being 1.804 per thousand. 



It is probable that organic disease of the liver, accompanied with 

 grave symptoms affecting usually the nervous system, does not differ; 

 in its pathology from cases of simple jaundice in the fact of retention oi 

 the biliary salts in the blood ; but these grave symptoms, it is more than 

 probable, are due to a deficiency in the elimination of cholesterin and its 

 consequent accumulation in the system. This condition may be char- 

 acterized by the name cholesteremia, a term expressing a pathological 

 condition, but at the same time indicating the physiological relations of 

 cholesterin. 



Koloman Miiller, in 1873, succeeded in injecting cholesterin into the 

 bloodvessels without producing any effects due to mechanical obstruc- 

 tion of the circulation. He made a preparation by rubbing cholesterin 

 with glycerin and mixing the mass with soap and water. He injected 

 into the veins of dogs 2.16 fluidounces (about 64 cubic centimeters) of 

 this solution, containing about 69 grains (4.5 grams) of cholesterin. In 

 five experiments of this kind, he produced a complete representation of 

 the phenomena of " grave jaundice." 



In view of all these facts, an excretory action of the liver, involving 



