(A) Bile And Bile Salts

The bile salts are sodium glycocholate and sodium taurocholate. They hold lecithin and cholesterol in solution in the bile, and serve as carriers of fats and soaps and their products into the villi of the intestine. They are then reabsorbed by the capillaries and returned to the liver by the portal vein. Owing to their ready excretion by the liver cells they act to increase the quantity of bile. In human bile from a biliary fistula Rosenbloom found 1.01 per cent. of total bile salts, and Yeo and Herroun found sodium taurocholate, 0.055 per cent., and sodium glycocholate, 0.165 Per cent. In human bile from the gall-bladder Hoppe-Seyler found 0.87 per cent. of the taurocholate and 3.03 per cent. of the glycocholate. Fresh ox-gall contains about 3 per cent. of the salts, but is variable- in its composition. The extract of ox-gall or dried ox-gall and mixtures of the salts are recommended in dose of 5 grains (0.3 gm.) to promote the production of bile, to promote the splitting and absorption of fats, and to enhance the action of the anthracene cathartics. They would seem to be contraindicated in obstructive jaundice, as in this condition the system is already overloaded with bile salts. In cases with biliary fistula Gerster reported that fresh bile through a stomach-tube (it cannot be swallowed) was successful in checking debility. Inouye and Sato find that 8 to 15 grains (0.5-1 gm.) of dried ox-gall, taken one hour before eating, promote the absorption of fat.