318 . Scientific Proceedings (130) 



8.5, while that of gall-bladder bile from the same animal may 

 fall as low as 5.18. Test tube experiments show that when liver 

 bile containing a crystalline sediment of the sort out of which 

 stones form is gradually brought to the average reaction of blad- 

 der bile, by the addition of N/10 HC1, or 3 per cent, acetic acid 

 or concentrated lactic acid, the sediment goes into solution. 



From these observations the inference seems justified that 

 many sorts of liver derangement conduce to the presence, in bile 

 that is sterile, of potential nuclei for calculus formation. But 

 the normal gall bladder effects precisely the sort of change in the 

 fluid that renders stone formation upon such nuclei impossible. 

 The organ does not merely concentrate 5 and store the bile, it 

 alters it so that it can be stored safely. In the lack of such altera- 

 tion, as when the gall bladder fails to function normally, it is 

 not surprising that stones should form. 



There are facts in the literature which indicate that the prin- 

 ciples here set forth apply to other species besides the dog. The 

 reaction of rabbit bile from gall bladders rendered abnormal by 

 typhoid infection is not acid like that from the healthy organ but 

 has the same alkalinity as liver bile. 4 And in such gall bladders 

 stones composed of calcium salts are regularly found if the animal 

 lives long. 6 This cholelithiasis has heretofore been attributed to 

 infection and inflammation, factors which are, at the most, ac- 

 cessory judging from the evidence here presented. We are now 

 attempting to determine whether the change in reaction has any 

 relation to the state of the cholesterin in human bile. 



5 Rous, Peyton, and McMaster, P. D., Jour. Exp. Med., 1921, xxxiv, 47. 



6 Meyer, K. F., Neilson, N. M., and Feusier, M. L., Jour. Infect. Vis, 1921, 

 xxviii, 76. 



