1892.] Icterus in Occluded Ductus Choledochus. 113 



VI. "Interference with Icterus in Occluded Ductus Chole- 

 dochus." By Vaughan Harley, M.D. Communicated by 

 George Harley, M.D., F.R.S. Received March 23, 1892. 



(From the Physiological Institute, Leipzig.) 



In 1880, Kufferath* pointed ont that when both the ducti thoracici — 

 right and left — and the ductus choledochus are ligatured icterus does 

 not appear. From his having only kept the dogs experimented upon 

 alive from 1 to 2^- hours, I was induced to test the value of the state- 

 ment by a series of experiments on animals kept alive for much longer 

 periods. 



The following are the results obtained, conducted under the 

 guidance of Professor Ludwig, to whom my best thanks are due for 

 the valuable assistance he gave me. 



The health of the animals experimented upon, I found, was not dis- 

 turbed by ligaturing the thoracic duct, if, after being kept fasting a 

 few days, they were carefully fed upon a fat-free diet ; and not only 

 so, bat that they might live for weeks and months and even increase 

 in weight. Nor did the additional ligaturing of the common bile 

 duct prove dangerous if done a few days previous to the application 

 of the ligature to the thoracic duct, and the dogs fed on food contain- 

 ing only small quantities of proteids. 



On the other hand, when both the thoracic and bile ducts were 

 ligatured at the same time, the animals frequently died a few days 

 after the operation, in consequence of rupture of the common bile 

 duct and the escape of bile into the peritoneal cavity inducing fatal 

 peritonitis. 



The experiments were conducted as follows : — After being operated 

 upon, each dog was kept separately in a place suitably arranged for 

 collecting its urine, which was daily examined for bile pigment by 

 Gmelin's test, and for bile acid (after being treated according to 

 Hoppe Seyler's method) by von Udranszky's test. After the death 

 of the animal the bile in the gall bladder was analysed. The portal 

 blood-vessels were injected, and, although the bile capillaries were 

 greatly distended, all attempts made to inject them proved unsuccess- 

 ful. In order to ascertain if the thoracic duct had been properly 

 ligatured it was carefully examined, and then injected with Berlin 

 blue, so as to find out if it had opened up any collateral lymphatics, 

 through which its lymph could find access to the general circulation. 



Of eighteen dogs thus experimented upon, two having died from 



* Kufferath, " Ueher die Abwesenheit der Grallens'aure im Blute nach dem Yer- 

 sehluss des G-allen- und des Milchbrustganges " (Du Bois-Reymond's* ' Archiv f. 

 Physiol.,' 1880, p. 92.) 



VOL. LI. I 



