198 REPORT—1868. 
Description oF THE Mopr or oprRAtING For BrzAry Fisrunai AND oF 
COLLECTING THE BILE PRACTISED BY THE ComMItrren. 
All the operations were performed by Dr. W. Rutherford, who ultimately 
succeeded in overcoming the great difficulties which presented themselves. 
The propriety of collecting the bile for a period of at least twenty-four hours 
at a time was considered incumbent to avoid error, a proceeding which caused 
great trouble and constant failures; it was considered necessary, however, 
in order to avoid the obvious fallacies into which all previous experimenters, 
with the exception of Dr. Scott, had fallen. In now giving a detailed de- 
scription of the method followed, the Committee are of opinion that they 
will save future experimenters much of that trouble and mortification which, 
from want of experience, they themselves encountered, It will be regarded 
as more valuable in consequence of the modifications which have been intro- 
duced having led to a far greater amount of success than has attended the 
efforts of other physiologists. 
1, Operation for establishing Biliary Fistule. 
1. Place the animal under the influence of chloroform, taking care to 
administer it slowly with an abundant admixture of air. 
2. Open the peritoneal cavity by an incision extending from the xiphoid 
cartilage to the umbilicus. Before opening the peritoneum, all bleeding 
should be stopped. 
3. Make an incision through a non-vaseular part of the omentum, to the 
same extent as the external wound. 
4, Find the gall-bladder and seize the most prominent part of its fundus 
with artery forceps. See if the fundus can be brought to the linea alba 
without subjecting it to any tension. Ifit can, proceed with the operation. 
if it cannot, judging from the experience of the Committee, it is better to 
abandon the operation altogether, as the dragging of the gall-bladder will 
almost certainly give rise to peritonitis, or such irritation as will prevent ad- 
hesion of the fundus to the cut edges of the linea alba. 
5. Find the common bile-duct; draw the duodenum gently downwards and 
towards the left side of the animal, and the liver upwards and to the right, so 
as to stretch the duct. 
6. With a blunt-pointed bistoury make an incision about one-eighth of an 
inch in length along the duct about its middle ; gently isolate it with the point 
of an ancurism needle, pass the aneurism needle with a double strong silk 
ligature round the duct, and tie it in two places, at a sufficient distance from 
each other to allow of the duct being simply divided between them. After 
division of the duet cut the ligatures close. 
7. Observe at what part of the linea alba the fundus can be most easily 
retained. Pass a curved needle with a silk ligature through the skin, linea 
alba, and gall-bladder on either side of the fundus, so as to stitch the gall- 
bladder to the linea alba, and retain it there. 
8. Make aslit by means of a sharp-pointed bistoury in the most prominent 
part of the fundus, and allow the bile to flow out, taking care to hold a sponge 
at the side of the opening to prevent, as much as possible, the entrance of bile 
into the peritoneal cavity. With the same view, the animal should be turned 
on its side before the opening is made in the gall-bladder. This opening 
should be just large enough to admit easily a piece of india-rubber tubing about 
two lines in diameter. 
