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ACHOLIC CACHEXIA: EXPERIMENTAL STUDIES

ACHOLIC CACHEXIA: EXPERIMENTAL STUDIES Abstract Acholic cachexia, or cachexia cholipriva, is a condition of rapid emaciation terminating fatally which results from complete external drainage of bile. It is indeed astonishing that the prompt fatal outcome of this condition has been recognized only in recent years. Wangensteen's1 recent review of the older literature revealed a truly astonishing series of statements made by many of the foremost scholars of the last two generations and continuing up to the early 1920's. Such able clinicians as Moynihan,2 Murphy,3 Courvoisier,4 Robson,5 Deaver6 and Balfour and Ross7 published comments on the apparent innocuousness of complete loss of bile. All believed it was harmless, although Balfour commented on anemia which usually appeared. Bernays,8 on clinical evidence, stated that "bile is almost if not entirely as much of a secretion as urine." However, since the decisive series of studies by Whipple and his co-workers, the References 1. Wangensteen, O. H.: Complete External Biliary Fistula: Potential Serious Postoperative Complications , J. A. M. A. 93:1199 ( (Oct. 19) ) 1929.Crossref 2. Moynihan, Berkley: Essays on Surgical Subjects: Acute Emergencies of Abdominal Disease , Philadelphia, W. B. Saunders Company, 1921, p. 144. 3. Ferguson, A. H.: Chicago M. Rec. 9:155, 1895. 4. Courvoisier, L. G.: Casuistisch-statistische Beiträge zur Pathologie und Chirurgie der Gallenwege , Leipzig, F. C. W. Vogel, 1890, vol. 12, p. 293. 5. Robson, A. W. M.: Observations on the Secretion of Bile in a Case of Biliary Fistula , Proc. Roy. Soc. London 47:499, 1890.Crossref 6. Deaver, J. B., in discussion on Heyd, C. G.: Cholecystogastrostomy and Courvoisier Gallbladder , J. A. M. A. 77:339 ( (July 30) ) 1921.Crossref 7. Balfour, D. C., and Ross, J. W.: Postoperative Biliary Fistulas , Arch. Surg. 3:582 ( (Nov.) ) 1921.Crossref 8. Bernays, A. C.: A Successful Case of Ideal Cholecystotomy, with Critical Remarks on the Pathology and the Different Operative Procedures Practiced on the System of Gall Vessels , Weekly M. Rev., Chicago 12:350, 1885. 9. Queen, F. B.; Hawkins, W. B., and Whipple, G. H.: Splenectomy in Bile Fistula Dogs , J. Exper. Med. 57:399, 1933.Crossref 10. Dostal, L. E., and Andrews, E.: Sixteen Months' Survival with Complete Biliary Obstruction in a Dog , Proc. Soc. Exper. Biol. & Med. 29:547, 1929. 11. McWhorter, G. L.: Congenital Cystic Dilatation of the Common Bile Duct , Arch. Surg. 8:604 ( (March) ) 1924. 12. Schwann, T. H.: Versuche um Auszumitteln ob die Galle im Organismus eine für das Leben wesentliche Rolle spielt , Arch. f. Anat. u. Physiol. , 1884, p. 127. 13. Bidder and Schmidt, quoted by Röhmann.14 14. Röhmann, F.: Beobachtungen an Hunden mit Gallenfistel , Arch. f. d. ges. Physiol. 29:509, 1882. 15. Ross, S. G.: A Study of Bile Secretion from a Case of Biliary Fistula , J. Lab. & Clin. Med. 12:1067, 1927. 16. Rous, P., and McMaster, P. D.: A Method for Permanent Sterile Drainage of Intra-Abdominal Ducts as Applied to a Common Duct , J. Exper. Med. 37:11, 1923. 17. Elman, R., and Hartmann, H. F.: Spontaneous Peptic Ulcers of Duodenum After Continued Loss of Total Pancreatic Juice , Arch. Surg. 23:1030 ( (Dec.) ) 1931. 18. Dostal, L. E., and Andrews, E.: Etiology of Gallstones: III. Effect of Diet on Bile Salt-Cholesterol Ratio , Arch. Surg. 26:258 ( (Feb.) ) 1933. 19. Kapsinow, R.; Engle, L. P., and Harvey, S. C.: Intra-Abdominal Biliary Exclusion from the Intestines: Cholecysto-Nephrostomy, a New Method , Surg., Gynec. & Obst. 39:65, 1924. 20. Puestow, C. B.: The Discharge of Bile into the Duodenum , Arch. Surg. 23:1013 ( (Dec.) ) 1931. 21. Dragstedt, L. R.; Haymond, H. E., and Ellis, J. C.: Cannula Gastrostomy and Enterostomy , Surg., Gynec. & Obst. 56:799, 1933. 22. Bloor, W. R.: The Determination of Cholesterol in Blood , J. Biol. Chem. 24:227, 1916. 23. Todd, J. C., and Sanford, A. H.: Clinical Diagnosis by Laboratory Methods , ed. 7, Philadelphia, W. B. Saunders Company, 1931. 24. Bloor, W. R.: Pelkan, K. F., and Allen, D. M.: Determination of Fatty Acids in Small Amounts of Blood Plasma , J. Biol. Chem. 52:191, 1922. 25. Clark, E. P., and Collip, J. B.: A Study of the Tisdall Method of Determination of Calcium of Blood Serum with a Suggested Modification , J. Biol. Chem. 63:461, 1925. 26. Kramer, B., and Tisdall, F. F.: A Simple Technic for the Determination of Calcium and Magnesium in Small Amounts of Blood Serum , J. Biol. Chem. 48:339, 1921. 27. Andrews, E., and Hrdina, Leo: A Method for Estimation of Both Bile Salts and Cholesterol in Small Amounts of Bile , Proc. Soc. Exper. Biol. & Med. 29:1102, 1932. 28. Schmidt, L. W., and Dart, A. E.: Estimations of Bile Acids in the Bile , J. Biol. Chem. 45:145, 1920. 29. Andrews, E.; Hrdina, L., and Dostal, L. E.: Etiology of Gallstones: II. Analysis of Duct Bile from Diseased Livers , Arch. Surg. 25:1081 ( (Dec.) ) 1932. 30. Foster, F. M.; Hooper, C. W., and Whipple, G. H.: Metabolism of Bile Acids: Normal Fluctuation in Healthy Bile Fistula Dogs , J. Biol. Chem. 38:367, 1919. 31. Stadelmann, E.: Ueber das Vorkommen von Gallensäuren Hippursäure und Benzoësäure in den Nebennieren , Ztschr. f. physiol. Chem. 18:380, 1893. 32. Foster, M. G.: Hooper, C. W., and Whipple, G. H.: Metabolism of Bile Acids: Administration by Stomach of Bile, Bile Acids, Taurine and Cholic Acid to Show Influence upon Bile Acid Elimination , J. Biol. Chem. 38:379, 1919. 33. Pfaff, F., and Balch, A. W.: An Experimental Investigation of Some of the Conditions Influencing the Secretion and Composition of Human Bile , J. Exper. Med. 2:49, 1897. 34. Brand, J.: Beiträge zur Kenntnis der menschlichen Galle , Arch. f. d. ges. Physiol. 90:494, 1902. 35. Wisner, F. P., and Whipple, G. H.: Bile Salt Metabolism: Variations in the Output of Bile Salts Pigments During Twenty-Four Hour Periods , Am. J. Physiol. 60:119, 1922. 36. Balderston, S. V.: Anemia Associated with Biliary Fistula , Arch. Int. Med. 50:223 ( (Aug.) ) 1932. 37. (a) Seyderhelm, R., and Tammann, H.: Ueber die Blutmauserung: Die Gallenfistelanämie des Hundes , Ztschr. f. d. ges. exper. Med. 57:641, 1927. 38. (b) Baumann, W. (Göttingen): Ueber die Blutmauserung: Weitere Untersuchungen über die zur Entstehung der Gallenfistelanämie führenden Störungen , Ztschr. f. d. ges. exper. Med. 75:401, 1931. 39. (a) Whipple, G. H., and Smith, H. P.: Bile Salt Metabolism: V. Proline, Tryptophane and Glycine in Diet , J. Biol. Chem. 89:705, 1930. 40. (b) Hawkins, W. B.; Sribhishaj, K.; Robscheit-Robbins, F. S., and Whipple, G. H.: Bile Pigment and Hemoglobin Interrelation in Anemic Dogs , Am. J. Physiol. 96:463, 1931. 41. Foster, F. M.; Hooper, C. W., and Whipple, G. H.: Metabolism of Bile Acid: IV. Endogenous and Exogenous Factors , J. Biol. Chem. 38:393, 1919. 42. Whipple, G. H.: Origin and Significance of the Constituents of Bile , Physiol. Rev. 2:440, 1922. 43. Pavlov, I. P.: The Work of the Digestive Glands , translated into English by W. H. Thompson, ed. 2, London, C. Griffin and Company, 1910. 44. Düttmann, G.: Die Veränderung des Säure-Basengleichgewichtes nach Gallenfisteln und ihre Bedeutung bei der Entstehung der sogenannten porotischen Malacie , Beitr. z. klin. Chir. 139:720, 1927. 45. Okada, S.: On the Secretion of Bile , J. Physiol. 59:457, 1915. 46. Neilson, N. M., and Meyer, K. F.: Reaction and Physiology of Hepatic Duct and Cystic Bile of Various Laboratory Animals , J. Infect. Dis. 28:510, 1921. 47. Jones, K. K.: Comparison of Buffer Value of Bile and Pancreatic Juice Secreted Simultaneously , Proc. Soc. Exper. Biol. & Med. 28:567, 1931. 48. Aronsohn, H. G., and Andrews, E.: Nonbacterial Cholecystitis: Mechanism of Acidification of Bile in the Gallbladder , Proc. Soc. Exper. Biol. & Med. 33:89, 1935. 49. Dragstedt, L. R., and Ellis, J. C.: Fatal Effect of Total Loss of Gastric Juice , Proc. Soc. Exper. Biol. & Med. 26:305, 1929. 50. Van Slyke, D. D., and Cullen, G. E.: Studies on Acidosis , J. Biol. Chem. 30:289, 1917. 51. Whitehorn, J. C.: Simplified Method for the Determination of Chlorides in Blood or Plasma , J. Biol. Chem. 55:499, 1921. 52. Kim, M. S., and Ivy, A. C.: Prevention of Experimental Duodenal Ulcer by Feeding Neutral Gastric Mucin , J. A. M. A. 97:1511 ( (Nov. 21) ) 1931. 53. Bollman, I., and Mann, F. C.: Peptic Ulcer in Experimental Obstructive Jaundice , Arch. Surg. 24:126 ( (Jan.) ) 1932. 54. Berg, B. N., and Jobling, J. W.: Biliary and Hepatic Factors in Peptic Ulcers: An Experimental Study , Arch. Surg. 20:997 ( (June) ) 1930. 55. McRoberts, J. W.: Effect of Exclusion of Bile on Reaction of Duodenal Contents , Proc. Staff Meet., Mayo Clin. 7:453, 1932. 56. Still, K. S., and Carlson, A. J.: Motor and Secretory Activity of Stomach During Acute and Chronic Obstructive Jaundice in Dogs , Am. J. Physiol. 74:34, 1929. 57. Heller, E.: Hämorrhagische Diathese ohne Ikterus bei vollständiger äusser Gallenfistel , Deutsche Ztschr. f. Chir. 235:667, 1932. 58. Pflüger, E.: Die Resorption der Fette vollzieht sich durch, dass sie in wässrige Losung gebracht werden , Arch. f. d. ges. Physiol. 86:1, 1901. 59. Dastre, A.: Du rôle de la bile dans la digestion des matières grasses , Compt. rend. Soc. de biol. 4:782, 1887. 60. Levin, I.: Ueber den Einfluss der Galle und des Pancreassaftes auf die Fettresorption in Dünndarm , Arch. f. d. ges. Physiol. 63:171, 1896. 61. Rachford, B. K.: The Influence of Bile on the Fat Splitting Properties of Pancreatic Juice , J. Physiol. 12:72, 1891. 62. von Fürth, O., and Schütz, J.: Ein Beitrag zur Methodik der Versuche über Fettresorption aus isolierten Darmschlingen , Beitr. z. chem. Phys. u. Path. 10:462, 1907. 63. Munk, I.: Ueber die Resorption von Fetten und festen Fettsäuren nach Ausschluss der Gallen vom Darmkanal , Virchows Arch. f. path. Anat. 122:302, 1890. 64. Verzár, F., and Kúthy, A.: Die Verbindung der gepaarten Gallensäuren mit Fettsäuren und ihre Bedeutung für die Fettresorption; Löslichkeit und Diffusibilität , Biochem. Ztschr. 210:265, 1929. 65. Seifert, E.: Zur Frage der porotischen Malazie nach Gallenfisteln , Beitr. z. klin. Chir. 136:496, 1926. 66. (b) Tammann, H.: Ueber die Beeinflussung der porotischen Osteomalazie nach Gallenfistel durch das D-Vitamin , Beitr. z. klin. Chir. 142:83, 1928. 67. Emerson, W. C.: Distribution of Calcium in Jaundiced and Acholic Dogs , J. Lab. & Clin. Med. 14:122, 1928. 68. Murakami, K.: Ueber die Gallensäurebildung; Avitaminosen und Gallensäure-ausscheidung in der Galle , J. Biochem. 9:321, 1928. 69. Heymann, W.: Untersuchungen über die Phosphatstoffwechselstörung bei Rachitis; über Rachitis und Tetanie bei Gallenfistelhunden , Ztschr. f. Kinderh. 54:201, 1933. 70. (a) Greaves, J. D., and Schmidt, C. L. A.: Studies on Calcium and Phosphorus in Bile Fistula Dogs , Proc. Soc. Exper. Biol. & Med. 29:373, 1932 71. (b) The Rôle Played by Bile in the Absorption of Vitamin D in the Rat , J. Biol. Chem. 102:101, 1933. 72. Dietrich, H.: Die porotische Malacie nach Gallenfistel , Beitr. z. klin. Chir. 134:530, 1925. 73. Takasu, M.: Experimentelle Studien über die acholische Kachexie , Deutsche Ztschr. f. Chir. 224:240, 1930. 74. Buchbinder, W. C., and Kern, R.: Experimental Obstructive Jaundice: I. Growth Factor in Defective Calcification , Arch. Int. Med. 40:900 ( (Dec.) ) 1927 75. Blood Calcium Deficiency in Experimental Obstructive Jaundice , Am. J. Physiol. 80:273, 1927. 76. Gilbert, E.: Ueber die Kalkausscheidung durch die Galle , Ztschr. f. d. ges. exper. Med. 53:539, 1924. 77. Andrews, E.; Schoenheimer, R., and Hrdina, L.: Etiology of Gallstones: I. Chemical Factors and the Rôle of the Gallbladder , Arch. Surg. 25:796 ( (Oct.) ) 1932. 78. Andrews, E., and Hrdina, L.: Absorption of Calcium from the Gallbladder , Am. J. M. Sc. 181:478, 1931. 79. Phemister, D. B.; Day, L., and Hastings, A. B.: Calcium Carbonate Gallstones and Their Experimental Production , Ann. Surg. 94:595, 1932. 80. von Beznák, A.: Der Einfluss der Galle auf die Resorption des Calciums , Arch. f. d. ges. Physiol. 228:604, 1931. 81. Brougher, J. C.: Effect of Ligation of the Common Bile Duct upon the Appearance of Tetany in Thyroparathyroidectomized Dogs , Am. J. Physiol. 84:39, 1928. 82. Sekitoo, T.: Ueber den Einfluss der Gallensäure auf den Calciumstoffwechsel , J. Biochem. 12:59, 1930 83. Beiträge zur Kenntnis der Glykocholeinsäure aus Kaninchengalle , Ztschr. f. physiol. Chem. 199:225, 1931. 84. Fuziwara, K.: Ueber den Einfluss der Gallensäure auf den Calciumstoffwechsel: Calciumausscheidung im Kot bei Zufuhr von Cholsäure , J. Biochem. 13:465, 1931. 85. King, J. H.: Bigelow, J. E., and Pearce, L.: Experimental Obstructive Jaundice , J. Exper. Med. 14:159, 1911. 86. Hastings, A. B.; Murray, C. D., and Sendary, J.: Studies of the Solubility of Calcium Salts , J. Biol. Chem. 71:731, 1931. 87. Bodansky, A.; Jaffe, H. L., and Chandler, J. P.: Serum Phosphatase Changes in Calcium Deficiency and in Ammonium Chloride Osteoporosis , Proc. Soc. Exper. Biol. & Med. 29:871, 1932. 88. Bodansky, A., and Jaffe, H. L.: Phosphatase Studies: Serum Phosphatase of Non-Osseous Origin; Significance of Variations of Serum Phosphatase in Jaundice , Proc. Soc. Exper. Biol. & Med. 31:107, 1933. 89. Gardner, J. A., and Gainsborough, H.: Blood Cholesterol Studies in Biliary and Hepatic Disease , Quart. J. Med. 23:465, 1930. 90. Garside, E.: Effect of Complete Biliary Fistula on Blood Cholesterol , Proc. Soc. Exper. Biol. & Med. 28:336, 1930. 91. McNee, J. W.: Zur Frage des Cholesteringehalts der Galle während der Schwangerschaft , Deutsche med. Wchnschr. 39:994, 1913. 92. Gainsborough, H.: A Study of So-Called Lipoid Nephrosis , Quart. J. Med. 23:101, 1930. 93. Fox, F. W.: The Composition of Human Bile and Its Bearing upon Sterol Metabolism , Quart. J. Med. 21:107, 1927. 94. Pribram, E. C.: Zur Frage des Cholesterinstoffwechsels während der Schwangerschaft und im Wochenbelt , Arch. f. Gynäk. 120:90, 1923. 95. (a) Smith, H. P.; Groth, A. H., and Whipple, G. H.: Bile Salt Metabolism: I. Control Diets, Methods and Fasting Output , J. Biol. Chem. 80:659, 1928. 96. (b) Smith, H. P., and Whipple, G. H.: Salt Metabolism: II. Influence of Meat and Meat Extractives, Liver and Kidney, Egg Yolk and Yeast in Diet , J. Biol. Chem. 80:671, 1928. 97. Neuman, C. E.: Beiträge zum Studium der Gallenniederschläge und Gallensteinbildung , Beitr. z. path. Anat. u. z. allg. Path. 84:187, 1931. 98. Ravdin, I. S.; Riegel, C.; Johnston, C. G., and Morrison, P. J.: Studies in Biliary Tract Disease , J. A. M. A. 103:1504 ( (Nov. 17) ) 1934. 99. Schoenheimer, R.: Newer Contributions to Sterol Metabolism , Science 74:579, 1931. 100. Sperry, W. M.: Lipid Excretion: IV. A Study of the Relationship of Bile to the Fecal Lipids with Special Reference to Certain Problems of Sterol Metabolism , J. Biol. Chem. 71:351, 1927. 101. Gardner, J. A., and Fox, F. W.: On the Origin and Destiny of Cholesterol in the Animal Organism: XII. On the Excretion of Sterols in Man , Proc. Roy. Soc. London, s.B. 92:358, 1921. 102. Fox, F. W.: The Origin and Destiny of Cholesterol in the Animal Body: XIV. The Cholesterol Metabolism in Normal Breast Fed Infants , Proc. Roy. Soc. London, s.B. 98:76, 1925. 103. Thannhauser, S. J., and Schaber, H.: Kann der tierische Organismus Cholesterin synthetisieren? Ztschr. f. physiol. Chem. 127:278, 1923. 104. Beumer, H., and Lehmann, F.: Ueber die Cholesterinbildung im Tierkörper , Ztschr. f. d. ges. exper. Med. 37:274, 1923. 105. Randles, F. S., and Knudson, A.: Studies on Cholesterol: I. Synthesis of Cholesterol in the Animal Body , J. Biol. Chem. 66:459, 1925. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

ACHOLIC CACHEXIA: EXPERIMENTAL STUDIES

Archives of Surgery , Volume 32 (4) – Apr 1, 1936

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Copyright © 1936 American Medical Association. All Rights Reserved.
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Abstract

Abstract Acholic cachexia, or cachexia cholipriva, is a condition of rapid emaciation terminating fatally which results from complete external drainage of bile. It is indeed astonishing that the prompt fatal outcome of this condition has been recognized only in recent years. Wangensteen's1 recent review of the older literature revealed a truly astonishing series of statements made by many of the foremost scholars of the last two generations and continuing up to the early 1920's. Such able clinicians as Moynihan,2 Murphy,3 Courvoisier,4 Robson,5 Deaver6 and Balfour and Ross7 published comments on the apparent innocuousness of complete loss of bile. All believed it was harmless, although Balfour commented on anemia which usually appeared. Bernays,8 on clinical evidence, stated that "bile is almost if not entirely as much of a secretion as urine." However, since the decisive series of studies by Whipple and his co-workers, the References 1. Wangensteen, O. H.: Complete External Biliary Fistula: Potential Serious Postoperative Complications , J. A. M. A. 93:1199 ( (Oct. 19) ) 1929.Crossref 2. Moynihan, Berkley: Essays on Surgical Subjects: Acute Emergencies of Abdominal Disease , Philadelphia, W. B. Saunders Company, 1921, p. 144. 3. Ferguson, A. H.: Chicago M. Rec. 9:155, 1895. 4. Courvoisier, L. G.: Casuistisch-statistische Beiträge zur Pathologie und Chirurgie der Gallenwege , Leipzig, F. C. W. Vogel, 1890, vol. 12, p. 293. 5. Robson, A. W. M.: Observations on the Secretion of Bile in a Case of Biliary Fistula , Proc. Roy. Soc. London 47:499, 1890.Crossref 6. Deaver, J. B., in discussion on Heyd, C. G.: Cholecystogastrostomy and Courvoisier Gallbladder , J. A. M. A. 77:339 ( (July 30) ) 1921.Crossref 7. Balfour, D. C., and Ross, J. W.: Postoperative Biliary Fistulas , Arch. Surg. 3:582 ( (Nov.) ) 1921.Crossref 8. Bernays, A. C.: A Successful Case of Ideal Cholecystotomy, with Critical Remarks on the Pathology and the Different Operative Procedures Practiced on the System of Gall Vessels , Weekly M. Rev., Chicago 12:350, 1885. 9. Queen, F. B.; Hawkins, W. B., and Whipple, G. H.: Splenectomy in Bile Fistula Dogs , J. Exper. Med. 57:399, 1933.Crossref 10. Dostal, L. E., and Andrews, E.: Sixteen Months' Survival with Complete Biliary Obstruction in a Dog , Proc. Soc. Exper. Biol. & Med. 29:547, 1929. 11. McWhorter, G. L.: Congenital Cystic Dilatation of the Common Bile Duct , Arch. Surg. 8:604 ( (March) ) 1924. 12. Schwann, T. H.: Versuche um Auszumitteln ob die Galle im Organismus eine für das Leben wesentliche Rolle spielt , Arch. f. Anat. u. Physiol. , 1884, p. 127. 13. Bidder and Schmidt, quoted by Röhmann.14 14. Röhmann, F.: Beobachtungen an Hunden mit Gallenfistel , Arch. f. d. ges. Physiol. 29:509, 1882. 15. Ross, S. G.: A Study of Bile Secretion from a Case of Biliary Fistula , J. Lab. & Clin. Med. 12:1067, 1927. 16. Rous, P., and McMaster, P. D.: A Method for Permanent Sterile Drainage of Intra-Abdominal Ducts as Applied to a Common Duct , J. Exper. Med. 37:11, 1923. 17. Elman, R., and Hartmann, H. F.: Spontaneous Peptic Ulcers of Duodenum After Continued Loss of Total Pancreatic Juice , Arch. Surg. 23:1030 ( (Dec.) ) 1931. 18. Dostal, L. E., and Andrews, E.: Etiology of Gallstones: III. Effect of Diet on Bile Salt-Cholesterol Ratio , Arch. Surg. 26:258 ( (Feb.) ) 1933. 19. Kapsinow, R.; Engle, L. P., and Harvey, S. C.: Intra-Abdominal Biliary Exclusion from the Intestines: Cholecysto-Nephrostomy, a New Method , Surg., Gynec. & Obst. 39:65, 1924. 20. Puestow, C. B.: The Discharge of Bile into the Duodenum , Arch. Surg. 23:1013 ( (Dec.) ) 1931. 21. Dragstedt, L. R.; Haymond, H. E., and Ellis, J. C.: Cannula Gastrostomy and Enterostomy , Surg., Gynec. & Obst. 56:799, 1933. 22. Bloor, W. R.: The Determination of Cholesterol in Blood , J. Biol. Chem. 24:227, 1916. 23. Todd, J. C., and Sanford, A. H.: Clinical Diagnosis by Laboratory Methods , ed. 7, Philadelphia, W. B. Saunders Company, 1931. 24. Bloor, W. R.: Pelkan, K. F., and Allen, D. M.: Determination of Fatty Acids in Small Amounts of Blood Plasma , J. Biol. Chem. 52:191, 1922. 25. Clark, E. P., and Collip, J. B.: A Study of the Tisdall Method of Determination of Calcium of Blood Serum with a Suggested Modification , J. Biol. Chem. 63:461, 1925. 26. Kramer, B., and Tisdall, F. F.: A Simple Technic for the Determination of Calcium and Magnesium in Small Amounts of Blood Serum , J. Biol. Chem. 48:339, 1921. 27. Andrews, E., and Hrdina, Leo: A Method for Estimation of Both Bile Salts and Cholesterol in Small Amounts of Bile , Proc. Soc. Exper. Biol. & Med. 29:1102, 1932. 28. Schmidt, L. W., and Dart, A. E.: Estimations of Bile Acids in the Bile , J. Biol. Chem. 45:145, 1920. 29. Andrews, E.; Hrdina, L., and Dostal, L. E.: Etiology of Gallstones: II. Analysis of Duct Bile from Diseased Livers , Arch. Surg. 25:1081 ( (Dec.) ) 1932. 30. Foster, F. M.; Hooper, C. W., and Whipple, G. H.: Metabolism of Bile Acids: Normal Fluctuation in Healthy Bile Fistula Dogs , J. Biol. Chem. 38:367, 1919. 31. Stadelmann, E.: Ueber das Vorkommen von Gallensäuren Hippursäure und Benzoësäure in den Nebennieren , Ztschr. f. physiol. Chem. 18:380, 1893. 32. Foster, M. G.: Hooper, C. W., and Whipple, G. H.: Metabolism of Bile Acids: Administration by Stomach of Bile, Bile Acids, Taurine and Cholic Acid to Show Influence upon Bile Acid Elimination , J. Biol. Chem. 38:379, 1919. 33. Pfaff, F., and Balch, A. W.: An Experimental Investigation of Some of the Conditions Influencing the Secretion and Composition of Human Bile , J. Exper. Med. 2:49, 1897. 34. Brand, J.: Beiträge zur Kenntnis der menschlichen Galle , Arch. f. d. ges. Physiol. 90:494, 1902. 35. Wisner, F. P., and Whipple, G. H.: Bile Salt Metabolism: Variations in the Output of Bile Salts Pigments During Twenty-Four Hour Periods , Am. J. Physiol. 60:119, 1922. 36. Balderston, S. V.: Anemia Associated with Biliary Fistula , Arch. Int. Med. 50:223 ( (Aug.) ) 1932. 37. (a) Seyderhelm, R., and Tammann, H.: Ueber die Blutmauserung: Die Gallenfistelanämie des Hundes , Ztschr. f. d. ges. exper. Med. 57:641, 1927. 38. (b) Baumann, W. (Göttingen): Ueber die Blutmauserung: Weitere Untersuchungen über die zur Entstehung der Gallenfistelanämie führenden Störungen , Ztschr. f. d. ges. exper. Med. 75:401, 1931. 39. (a) Whipple, G. H., and Smith, H. P.: Bile Salt Metabolism: V. Proline, Tryptophane and Glycine in Diet , J. Biol. Chem. 89:705, 1930. 40. (b) Hawkins, W. B.; Sribhishaj, K.; Robscheit-Robbins, F. S., and Whipple, G. H.: Bile Pigment and Hemoglobin Interrelation in Anemic Dogs , Am. J. Physiol. 96:463, 1931. 41. Foster, F. M.; Hooper, C. W., and Whipple, G. H.: Metabolism of Bile Acid: IV. Endogenous and Exogenous Factors , J. Biol. Chem. 38:393, 1919. 42. Whipple, G. H.: Origin and Significance of the Constituents of Bile , Physiol. Rev. 2:440, 1922. 43. Pavlov, I. P.: The Work of the Digestive Glands , translated into English by W. H. Thompson, ed. 2, London, C. Griffin and Company, 1910. 44. Düttmann, G.: Die Veränderung des Säure-Basengleichgewichtes nach Gallenfisteln und ihre Bedeutung bei der Entstehung der sogenannten porotischen Malacie , Beitr. z. klin. Chir. 139:720, 1927. 45. Okada, S.: On the Secretion of Bile , J. Physiol. 59:457, 1915. 46. Neilson, N. M., and Meyer, K. F.: Reaction and Physiology of Hepatic Duct and Cystic Bile of Various Laboratory Animals , J. Infect. Dis. 28:510, 1921. 47. Jones, K. K.: Comparison of Buffer Value of Bile and Pancreatic Juice Secreted Simultaneously , Proc. Soc. Exper. Biol. & Med. 28:567, 1931. 48. Aronsohn, H. G., and Andrews, E.: Nonbacterial Cholecystitis: Mechanism of Acidification of Bile in the Gallbladder , Proc. Soc. Exper. Biol. & Med. 33:89, 1935. 49. Dragstedt, L. R., and Ellis, J. 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Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1936

References