Series of experiments on dogs leading to the following conclusions: 1. Contrary to accepted pathological doctrine, the bile which is eliminated by the urine and deposited in the skin, in cases of ob structive jaundice, does not find its way into the general circulation through being absorbed by the blood-capillaries.
2. It is the lymphatic system of vessels alone which absorbs the biliary matters in obstructive jaundice, and it is through the instrumentality of the thoracic duct that they' reach the general circulation.
3. After the thoracic duct has been liga tured for some days, supplementary ducts form by the coalescence of either entirely new or pre-existing, small, collateral lymphatics from the thoracic duct, at a point below the seat of ligature, through which its lymph-stream passes vicari ously into the right innominate vein. 4. After the common bile-duet is ligatured, the whole of the constituents of the pent up bile do not become equally concen trated, the less soluble, such as choles terin and mucin, being by far the most concentrated. 5. From the dogs experi mented on having, in many cases, not only lived, but even gained in weight, after bile was prevented from finding its way into the duodenum, it may be ih ferred that the admission of bile into the digestive canal is not absolutely' essential to life. 6. Ligaturing the thoracic duct not only prevents the occurrence of ob structive jaundice, after the occlusion of the common bile-duct in dogs, but checks it even after it bas set in. Vaughan Harley (Brit. Med. Jour., Aug. 20, '92).
By. the aid of injected and safranin stained microscopical liver preparations the following facts demonstrated: 1. The secretion-vacuoles of the liver discovered by Kopffer do not form the terminals of the bile-ellannels, but the liver-cells are filled witb a fine canal-reticulum sur rounding the nucleus; this reticulum is continuous with the intercellular bile capillaries. 2. An injection of the liver cells is possible by way of the blood vessels, since a dense net-work of blood capillaries surrounds the nuclei of the liver-cells. From these results the new theory submitted in reference to conges tion-jaundice: In entering the blood channels it is not necessary that the bile should go by the route of the thoracic duct; admission to the blood may occur in the liver-cells themselves by diffusion from the bile-capillaries surrounding the nuclei into the neighboring blood-capil laries. C. Nauwerck (Munch. med.
'Woeh., xliv, 2).
Many of the secretions are also colored with bile-pigment. The sweat is yellow and stains the patient's linen. The tears and milk may also be colored, but the saliva is not stained nor do the secretions of the mucous membranes, not even of the bile-ducts and gall-bladder, contain any bile.
Inflammatory exudates, as the sputa of pnemnonia, are bile-stained, as are also the exudates into the various serous cavities.
Since the removal of diffusible sub stances in the blood is chiefly by the kid neys, it follows that the urine contains more of the biliary coloring matter than any other secretion. It may be present in the urine before it appears in the con junctiva even. The color of the urine may vary from a barely perceptible greenish-yellow to a dark-brown or even black color. Bile-pigment is invariably present in the urine in jaundice, except in chronic cases in which the obstruction to the bile-flow is suddenly removed, when the icteric hue of the skin will per sist after the blood has been cleared of the bile-pigment. Bile-stained urine foams readily when shaken, and the froth is of a yellow color. Rhubarb and san tonin, when administered, produce a similar color in the urine, but the froth is not yellow; the addition of caustic potash causes a red coloring of the fluid and the tests for bile-pigments are not obtained.
Ginelin's test is usually employed to determine the presence of bile-pigment, but it may fail to give a reaction even in the presence of 5 per cent. of bile. It is best made by placing a fesv drops of com mon nitric acid and of the urine on a ,tt. t surfact and :lit causing then t,. run :.,gt tht r. A of colors result. t; t 1..ar.....;11 of cont.wt, rapidly passin", anvils shades of green, blue ,lt t, and rid. funny btcoming a dirt rh, f( ing modification of it i; re delicate. revealing, even itrtt nt. cf bile, and should be employeC. In doul.tful cases: -To 50 cubic centi.