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414 THE LIVER.
tions, with abundance of codfish and then found so much glycogen (6.46
per cent in the liver and 1 per cent in the muscle) that a re-formation of
glycogen must have undoubtedly occurred. By special control exper-
iments with fat feeding they also showed that the glycogen did not orig-
inate from the fat but must unquestionably have come from the protein.
Carbohydrates and proteins are without question true glycogen-formers,
while the question in regard to fats is still open.
The Bile and Its Formation.
By the establishment of a biliary fistula, an operation which was
first performed by Schwann in 1844 and which has been improved lately
by Dastre and Pawlow, 1
it is possible to study the secretion of the bile.
This secretion is continuous, but with varying intensity. It takes
place under a very low pressure; therefore an apparently unimportant
hindrance in the outflow of the bile, namely, a stoppage of mucus in the
exit, or the secretion of large quantities of viscous bile, may cause stagna-
tion and absorption of the bile by means of the lymphatic vessels (absorp-
tion icterus).
The quantity of bile secreted in the twenty-four hours in dogs can be
exactly determined. The quantity secreted by different animals varies,
and the limits are 2.9-36.4 grams.of bile per kilo of weight in the twenty-
four hours. 2
The reports as to the extent of bile secretion in man are few and
not to be depended on. Noel-Payton, Mayo-Robson, Hammarsten,
Pfaff and Balch, and Brand 3 found a variation between 514 and
1083 cc. per twenty-four hours. Such determinations are of doubtful
value, because in most cases it follows from the composition of the
collected bile that the fluid is not the result of a secretion of normal liver
bile.
The quantity of bile secreted is, however, as shown by Stadel-
mann,4
subject to such great variation, even under physiological con-
ditions, that the study of those circumstances which influence the secre-
tion is very difficult and uncertain. The contradictory statements
by different investigators may probably be explained by this fact.
1
Schwann, Arch. f. (Anat. u.) Physiol., 1844; Dastre. Arch, de Physiol. (5i) 2;
Pawlow, Ergebnisse der Physiol., 1, Abt. 1.
2
In regard to the quantity of bile secreted in animals see Heidenhain, Die Gallenab-
eonderung, in Hermann’s Handbuch der Physiol., 5, and Stadelmann, Der Icterus und
seine verschiedenen Formen (Stuttgart, 1891).
3
Noel-Payton, Rep. Lab. Roy. Coll. Edinburgh, 3; Mayo-Robson, Proc. Roy. Soc,
47; Hammarsten, Nova Act. Reg. Soc. Scient. Upsala (3), 16; Pfaff and Balch, Journ,
of Exp. Med., 1897; Brand, Pfluger’s Arch., 90.
4
Stadelmann, Der Icterus, etc., Stuttgart, 1891.
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