460 CHEMISTRY OF THE DIGESTIVE PROCESSES. 
and estimated the amount of fatty material in the stomach and intestine. The 
amount so found was usually slightly in excess of that given in the food, the 
surplus being probably due to intestinal secretion or excretion. Lewin, 1 as a 
result of microscopic examination of sections of the intestine, concludes that fat 
absorption does not take place in a normal manner if bile or pancreatic juice, or 
both, are kept from entering the intestine. He also found under such circum- 
stances that the lacteals did not present the usual milky appearance which 
accompanies fat absorption. 
The effect of a biliary fistula on fat absorption seems to be identical 
with that of a pancreatic fistula ; exactly the same kinds of results have 
been recorded in the two cases. All observers are agreed that so natch 
fat cannot be absorbed in presence of a biliary fistula as when bile has 
access to the intestine, but, while some find fat absorption practically 
arrested, others have observed that a considerable, nearly normal, amount 
of fat can still be disposed of. As in the case of absence of the pan- 
creatic secretion, most of the unabsorbed fat is found in the fa-ces as 
fatty acid. 2 
Rohmann 3 also found that sodium soaps were not absorbed, but were 
converted into free fatty acids, and appeared as such in the fasces. Bidder 
and Schmidt 4 state that normal dogs can digest as much as seven times the 
quantity of fat which can be disposed of by dogs with fistula of the gall bladder, 
and that, while during fat absorption in a normal dog the lacteals are tilled with 
milky chyle, they are, under similar conditions in a dog with a biliary fistula, 
Idled with a yellow or slightly opalescent fluid. 
C. Voit 5 estimates the average loss of fat at 22 - 2 to 34 - 7 per cent.; Munk/' 
at 33T per cent. ; Rohmann," at 48*5 to 58*4 per cent. ; Noel Paton, 8 at 34"58 
per cent. ; Dastre, 9 at 57 - 65 per cent. Munk 10 found that the absorption of fats 
of high melting point (mutton) suffered more than that of fats of low melting 
point (hog's lard) ; of the former but 35'5 per cent, was utilised, of the latter 
67 per cent. He also found that the free fatty acids in the absence of bile were 
absorbed equally well, in fact slightly better, than the corresponding neutral 
fats. Dastre 11 ligatured the ductus choledochus, and made a fistula between 
the gall bladder and small intestine much lower down (60-150 cm.) ; he 
observed, after a meal of fat, that the lacteals were only injected with milky 
chyle below the artificial point of entry of the bile. As Dastre himself 
remarks, the result is more elegant than decisive. It is only qualitative in 
character, and does not show quantitatively the share taken by pancreatic 
juice and bile in fat absorption. Hedon and Ville 12 established first a biliary 
fistula, and afterwards removed nearly all the pancreas, leaving just enough of 
the tail to preserve the animal alive, and destroying all communication with 
the intestine. In this manner both bile and pancreatic juice were kept out of the 
intestine, and under such conditions the digestion and absorption of fat was 
1 Arch. f. d. gcs. Physiol., Bonn, 1896, Bd. lxiii. S. 171. Lcwiu removed the influence of 
both secretions by making a Thiry-Yella fistula of that part of the duodenum into M-hich 
the ducts open. 
- Rohmann, Arch./, d. gcs. Phi/sio/., Bonn, 1882. Bd. xxix. S. 509 : I. Munk, Virchow's 
Archiv, 1890, Bd. cxxii. S. 313 ; Hedon and Ville, Compt. rend. Soc. de tool., Paris, 1892, 
tome xliv. p. 309. See, however, Dastre, Arch, de physiol. norm, et path., Paris, 1891, 
tome xxiii. p. 186. 
3 Loc. <it., S. .":;•_'. ■* " Die Verdaunngssafte," etc. 
5 "Beitr. z. Biologie," Jubilaumsschriftf. v. Bischoff, Stuttgart, 1882. 
6 Virchovfs Archiv, 1890, Bd. cxxii. S. 302. 7 Loc. cit. 
s Sep. Lull. Roy, Coll. Phys., Edin., 1891, vol. iii. p. 214. The case was one of a com- 
plete biliary fistula in a woman. 
9 Loc. cit. 10 Loc. cit., S. 324, 325. " Loc. cit. l - Loc. cit. 
