Bile-secretion and Bile-pressure. 
9 
One explanation of this might be that while the pressure was 
rising in the manometer the liver was being distended with bile 
and when the pressure, which was the cause of this distension, 
was removed the elasticity of the liver tissue led mechanically 
to the increased expulsion of bile. To test the correctness of this 
explanation, I killed one animal with an overdose of chloroform 
when the bile pressure had attained its maximum and at the same 
time released the clamp obstructing the outflow. In this case 
the increased rate due to the escape of the bile from the gorged 
liver very quickly diminished and the flow soon stopped entirely. 
The cause is, therefore, probably not merely mechanical. 
To investigate this matter further, the escape of bile was ad- 
justed so that a certain pressure (170 mm. bile) could be main- 
tained in the manometer while the bile-flow was being registered 
by the drop-recorder, and in two cases — one sheep and one dog — 
it was found that the rate of bile-flow was greater than when the 
bile column stood at zero. At this pressure it is certain that a 
considerable quantity of bile was passing backwards and being 
adsorbed into the lymphatics so that the flow through the common 
bile duct did not account for all the bile that was being secreted. 
It is right to mention, however, that I observed this in only two 
experiments out of about twenty. 
The most obvious explanation of this phenomenon which 
suggests itself to me is that the passage of bile through the lym- 
phatics into the blood stimulates the liver cells to increased activity 
so that more bile is actually secreted. This is all the more probable 
since we know that the intravenous injection of a small quantity 
of bile or bile salts acts as a powerful cholagogue. In jaundice 
by obstruction it would appear therefore, that in the initial stages 
at all events, a kind of vicious circle is established whereby the 
bile absorbed stimulates the hepatic cells to produce more bile. 
This increased activity, which has for its object, no doubt, the 
removal of some obstruction in the bile passages, will at some 
stage be arrested, and may give place to partial or complete loss 
of function. 
