REACTION OF GALL BLADDER TO STIMULATION OF GASTROINTESTINAL TRACT

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Abstract
One egg-yolk injected into the duodenum induces a single phase of contraction of the gall bladder and evacuates f of its contents. The head of the column of bladder bile may be aspirated from the duodenum 7-15 min. after the injection of yolk. Injections of strong solutions of MgSO4, MgCl2, or Na2SO4 evacuate of the contents of the gall bladder, the column of bile reaching the duodenum as quickly as after egg-yolk. When given by mouth these salts are nearly, if not quite, as effective as when given by Rehfuss tube. Rochelle salt, or 1 of its constituents (sodium tartrate) never empties more than 1/3 of the contents of the gall bladder and is not consistent in its action. The aspirated bile is a lighter brown than the usual"B"bile. Other Na salts, such as NaCl, NaHC03, phosphate and citrate, induce temporary relaxation and filling of the gall bladder instead of emptying. Injection of HC1, in strengths found in the normal stomach, induces moderate changes in volume of the gall bladder (less than that caused by the tartrates), and may be in either direction. But its action is transitory and when positive never results in the aspiration of recognizable quantities of bladder bile. Alternating changes in the pH of the duodenal contents seem to have no appreciable effect on the tone of the gall bladder. Injection of liquid petrolatum causes initial inhibition of the gall bladder and retards its response to food subsequently injected into the duodenum. The latter effect is thought to be due to the local action of petrolatum in closing the sphincter. The simultaneous contraction of the gall bladder and opening of the sphincter after egg-yolk or MgSo4, together with the synchronous relaxation of the gall bladder and closing of the sphincter (Cole) after NaHC03, implies the existence of a reciprocal mechanism which is set in motion by a single reagent. Sudden contraction of the gall bladder following distention of the duodenum with air, or sudden relaxation (in certain individuals) accompanying the injection of fluids, suggests that the human gall bladder is subject to reflexes arising in the gastro-duodenal tract[long dash]a theory con-firmed by experiments on animals, as recorded in the companion article to this paper.

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