18tf0.] Secretion of Bile in a Case of Biliary Fistula. 499 



tions upon the moon in other phases would show experimentally 

 whether the percentage transmission by glass of the heat from an 

 element of the moon does depend on the altitude of the sun only, or 

 whether the altitude of the earth also has any influence, as, indeed, is 

 suggested by Lord Rosse in a note to his Bakerian Lecture (' Phil. 

 Trans.,' vol. 163, p. 626). It is unfortunate that I have not at pre- 

 sent made any other observations on the transmission by glass of the 

 moon's heat.— April 21, 1890.] 



IV. " Observations on the Secretion of Bile in a case of 

 Biliary Fistula." By A. W. Mayo Robson, F.R.C.S., Hon. 

 Surgeon, Leeds General Infirmary, Lecturer on Practical 

 Surgery at the Yorkshire College, and Examiner in the 

 Victoria University. Communicated by Dr. Clifford 

 Allbutt, F.R.S. Received April 3, 1890 * 



There are few physiological questions on which so much doubt and 

 disagreement prevail as on that of the secretion and uses of bile, 

 this being especially marked when we come to compare the appa- 

 rently contradictory observations of various experimenters relating 

 to the action of drugs on the biliary secretion. 



As the well known experiments of Dr. Rutherford and Messrs. 

 Prevost and Binet were conducted on the lower animals, it may 

 possibly account for the differences between their observations and 

 those recorded in this paper. From the rarity of cases of biliary 

 fistula in healthy human subjects, the opportunity has rarely occurred 

 for a careful analysis of fresh bile in sufficient quantity, or for a 

 complete analysis of the whole twenty-four hours' secretion ; and in 

 all previous analyses no notice has been taken of the gall-bladder 

 secretion. 



In the following cases, the fistulse remained open for long 

 periods after the initial operations, the total flow of bile or gall- 

 bladder secretion was carefully collected and accurately measured at 

 different times and for many consecutive hours at a time, and the 

 general good health of the patients was maintained throughout. 



Method of Collecting. 



The fluid was caught in a light glass flask, into the mouth of 

 which it was guided by means of a celluloid cannula, a substance 

 chosen after several trials with metal ones, on account of its lightness 

 and non -irritating qualities. 



* This paper is a revision of that read on January 16, under the title " Observa- 

 tions regarding the Secretion and Uses of Bile " (see p. 129, supra). 



