THE FUNCTION OF THE GALL-BLADDER

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Abstract
The author has long held that the gall-bladder is an organ of absorption and that the cystic duct is a oneway tube which normally admits bile into the gallbladder, but does not discharge it thence. He criticizes the methods of study hitherto employed: direct physiologic observation, on the ground that it introduces vitiating abnormal factors; introduction of lipiodol, on the ground that this substance, being non-absorbable, is unsuited for demonstration of physiologic function. The results obtained by cholecystography with Graham''s dye and by Lyon''s method of biliary drainage with Graham''s dye, he maintains, have not been properly interpreted. He suspects that "the function of the gall-bladder is to receive and return to the body the bile which is formed during the intervals between active digestion," especially, perhaps, during fetal life when no intestinal digestion is going on. This concept explains the occurrence of icterus neonatorum, the fact that fetal blood regularly shows hyperbilirubinemia, the steady increase of bile salts in the blood of pregnancy, the relation between gallstones and pregnancy, and the occurrence of gallstones in a normal bladder.

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