STUDIES ON GALLBLADDER FUNCTION. IX. THE ANION-CATION CONTENT OF BILE FROM THE NORMAL AND INFECTED GALLBLADDER

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Abstract
The authors previously reported the anioncation concentrations of certain constituents in normal and dog''s hepatic and gall bladder bile. When the gall bladder is normal it alters hepatic bile by concentrating the Ca, bile salt, and base. The chloride and total CO2 concentrations decrease and the pH is reduced. Fluid is always absorbed. When the gall bladder becomes damaged fluid pours into it. Base remains as in hepatic bile while bile salts and Ca decrease in concentration and chloride and total CO2 increase in concentration. The pH is increased. Normal human gall bladder bile is similar in its concentrations of the substances studied to normal dog gall bladder bile. Studies of human bile removed from the diseased gall bladder at operation have now been made. Changes similar to those obtained in the dog when the gall bladder is infected have been observed. Roughly the data from the diseased gall bladder are divisible into 3 groups on the basis of chemical analyses, and the ability of the gall bladder to concentrate its contents as evidenced after the administration of Na tetraiodophenolphthalein. With increasing damage there is a tendency for a reduction of bile salt and Ca, and an increase in chloride and total CO2 concentration, until in the non-visualized gall bladder containing stones, bile salts, as demonstrated by the Gregory-Pascoe reaction, are frequently absent, while chloride is above the blood level and Ca is present in approximately the same concentration as in hepatic bile. Between normal human gall bladder bile and that found in the severely damaged gall bladder one finds bile in which with increasing histologic evidences of disease the bile salt concentration decreases.

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