Volume 1

A clinical treatise on diseases of the liver / by Fried. Theod. Frerichs ; translated by Charles Murchison.

  • Frerichs, Friedrich Theodor, 1819-1885.
Date:
1860-1861
Catalogue details

Licence: Public Domain Mark

Credit: A clinical treatise on diseases of the liver / by Fried. Theod. Frerichs ; translated by Charles Murchison. Source: Wellcome Collection.

    126/440 (page 94)
    Its absorption into the blood takes place much earlier ;^ but in order tliat the jaundiced colour of the skin should become visible, a certain amomit of concentration is necessary. The colour makes its appear- ance m the renal secretion sooner than it does in the skin, and serous ettusions m the various cavities of the body become tinned with pigment earlier than the urine. I have repeatedly found cholepyrrliin in the serum of the blood, and in effusions into the abdominal and thoracic cavities, where no traces of a jaundiced tint had been present either m the urine or in the skiu.f Apart from the tinging of its plasma, the blood undergoes no remarkable change from the absorption of bile; its proximate principles vary, as numerous analyses have shown, according have usually led me to the same resiüt. After the application of a liga- ture to the common bile duct, the yellow colour of the conjunctiva was later. '''' '''^^ ^^ seventieth hour, and sometimes • As regards the rapidity of absorption, reference is generally made to the observations of Saundevs-(JbhandL über die Structur, Sfc, der Leier. Am dem Enghschen. Leipzig, 1795, S. 61)-who, so soon as two hours after the apphcation of a ligature to the ductus choledochus, found the lymphatics, as far as the thoracic duct, filled with a yellow fluid, and, in the same space of time, the serum of the blood of the hepatic vein darkly tinged, but that of the jugular vein scarcely at aU so. I have not from my own investigations, been able to confirm these statements. Four- anitwenty hours after the ligature of the ductus choledochus, bile- pigfiient could not be detected either in the serum of the blood the lymphatics, or the urine. On one ocasion, it was found in the blood of the jugular vem after twenty-eight hours; but on another occasion, there was not a trace. After forty-eight hours, the colouring-matter could be seen almost always in the blood and in the urine, but not, however in the contents of the thoracic duct. Sixty hours after the ligature, the cliyle was still white on one occasion, but on another it was yellow, and contained pigment. Cases have occurred in which, notwithstanding the complete obstruction of the bile ducts, not a trace of colouring-matter had appeared either in the blood or urine at the end of two days, and others, in which the serum was pale, and without the reaction of büe, but in which the blood, when digested in alcohol for some time, yielded a not inconsider- able quantity of cholepyrrhin, which was first formed from' chromo-ren during standing. t There are, however, exceptions to this; sometimes, along with the yellow colour of the skin, the urine contains no bile-pigment of the usual reaction, but colouring-matter of another nature, which is formed from It. Moreover, upon post-mortem examination, the comparative deposit of pigment is found to be greatest, at one time in the skin and at another in the kidneys.