Destiny of Cholesterol in the Animal Organism. 36 &• 



small positive balance. The negative balances are very variable, ranging^ 

 from 0'03 to 0'95 grm. per day. The average negative balance on diet A was 

 0-34, on diet B 0-46, on diet C 0-21, and on diet D 018. The high output on 

 diet B, with coarse bread, may possibly be accounted for by the somewhat, 

 laxative effect of the brown bread on some of the subjects — subject C, for 

 instance, was so relaxed that he was obliged to retire from the experiment. 

 He stated that brown bread always had this effect on him. The average 

 negative balance in the twenty -six experiments was 0"307. On comparing the 

 same individuals on different diets, a similar great variation will be noticed. 



The sterol excreted in the faeces is derived partly from the food and partly 

 from the bile. The determination of the amount of bile excreted per day hj 

 a human being is a very difficult problem, and as yet reliable data are 

 wanting. The amount is given in the text-books as from 500 to 1000 c.c. 

 per day. The figures are derived mainly from the study of patients with 

 biliary fistulae. We may quote a case of a woman with a biliary fistula 

 studied in some detail by Pfaff and Balch at the Massachusetts General 

 Hospital (1897). They found that the total bile excreted per day was 

 525 grm., but the amounts excreted at different periods of the day were 

 very variable. Such figures must, however, be taken with great reserve as 

 an index of the amount of bile produced in the normal subject. It is known, 

 that, if bile is passed into the intestine, the secretion is increased both in 

 concentration and in amount, and that fistula bile differs from bladder bile 

 both in concentration and even in composition. Thus, Pfaff and Balch's bile 

 contained only some 3 per cent, of total solid matter, while various observers 

 have given the solid content of bladder bile as 10 to 20 per cent. Further,, 

 the percentages of inorganic constituents iu fistula and bladder bile are of 

 quite different order. However, there appears to be a general consensus of 

 physiological opinion that in health, and when bile finds its way into the 

 intestine, the excretion is probably larger (rather than smaller) than in the 

 fistula cases. 



Very variable values have been recorded in the literature for the 

 cholesterol- content of bladder bile, and many of the figures must be 

 accepted with considerable reserve, particularly those obtained before the 

 development of modern methods of estimation of sterols. We know that 

 cholesterol is very soluble in bile, and Moore and Eoaf have shown that 

 ordinary bladder bile is able to dissolve a good deal more than is ordinarily 

 found. The cholesterol of the bile is mainly found in the non-ester con- 

 dition. In more recent years, Peirce (1912) has examined the cholesterol- 

 content of the gall-bladder bile in a variety of conditions by the digitonin 

 method. The results are variable, but he regards the normal figure as about 



