Observations on the secretion of bile in a case of biliary fistula / by A.W. Mayo Robson.

  • Robson, Arthur William Mayo, Sir, 1853-1933.
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the secretion of bile in a case of biliary fistula / by A.W. Mayo Robson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    4 gr. of iridin gave an effect not so pronounced, the inci'cased How- being intermittent. Apparently, the action of iridin is to increase the flow temporarily, without augmenting the total quantity in twenty-four houiS. Turpentine.—Messrs. Prevost and Binet state that turpentine and its derivatives promote a notable increase in the excretion. In order to test this, a turpentine capsule containing 15 min. of the oil of turpentine was given every four hours night and day. On Jan. 18th, no drug given. 27 oz. 6 dr. .36 min. were excreted in twenty-four hours. On Jan. 19th and 20th, during the adminis- tration of turpentine capsules, 28 oz. 5 dr. 41 min. were excreted, that is, an increase of 7 dr. During the following twenty-four hours, the capsules being continued, 30 oz. 2 dr. 10 min. were excreted. Durinc the third period of twenty-four hours with the capsules 26 oz. 57 min. were excreted; and during the fourth twenty-four tours 27 oz. 45 min. Therefore, although an increase was apparent on the second day, the daily amount of bile discharged in the twenty-four hours was not so much as on many days when no turpentine was being given, as, for instance, on Oct. 27th and 29th, when it was over 30 oz. Benzoate of Soda.—Messrs. Prevost and Binet state that the administration of benzoate of soda to dogs increased the amount of bile to two or three times the normal. This I do not find to be the result in Case I, as the table and charts appended will show, where no positive incx-ease is seen. Conclusions. First.—The bile is probably chiefly excrementitious, and, like the urine, is constantly being formed and cast out. Secondly.—Though the bile probably assists in the absorption of fats, its presence in the intestine is not necessary for the digestion of such an amount of fat as is capable of supporting life and keeping ' up nutrition. Thirdly.—Increase in body weight and good health are quite com- patible with the entire absence of bile from the intestines. Fourthly.-The antiseptic properties of the bile are unimportant. I'ifthly—Whatever little antiseptic quality bile may have is pro- bably derived from its admixture with the gall-bladder fluid. Sixthly.—The supposed stimulating effect of the bile on the intes- tinal walls is not necessary for a regular action of the bowels. Seventhly.—The quantity of bile excreted in the twenty-four hours, during health in a person of average weight, may vary between 39 oz. 4 dr. and 25 oz. 6 dr., with an average of 30 oz., less the 2i oz. of fluid secreted by the gall-bladder.