Volume 1

A clinical treatise on diseases of the liver / by Fried. Theod. Frerichs ; translated by Charles Murchison.

  • Friedrich Theodor von Frerichs
Date:
1860-1861
Catalogue details

Licence: Public Domain Mark

Credit: A clinical treatise on diseases of the liver / by Fried. Theod. Frerichs ; translated by Charles Murchison. Source: Wellcome Collection.

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    repeatedly confirmed, it lias been concluded, that there is an intimate relation between the biliary acids and the bile-pigment, and that in fact the former become converted into the latter when subjected to the influence of certain agencies j and it has been thought, that, under certain pathological conditions, the biliary acids normally present in the blood are transformed into bile-pigment. The de- tailed account of Prerich's experiments will be found in the section which treats of the Theory of Jaundice, and in the Appendix to the present volume. Since the appearance of Prerich's work, these views as well as the facts upon which they are founded, have been called in question by Dr. Kühne, {Virchow's Archiv., 2>rd and Uh Part of Vol. XIV., Sept. 1858); and as an abstract of Kiiline's paper has lately appeard in an English Medical Journal, and may have some influence with English readers [Archives of Medicine, edited by Br. Beale, Vol. I., p. 342, March, 1859), it demands a brief notice here. Kühne maintains that biliary acids do constitute an integral part of jaun- diced urine, and he attributes the circumstance of their not having been hitherto demonstrated, to the insnfficiency of the tests em- ployed for the purpose. The method which he has followed has been that of Dr. Eelix Hoppe, an account of which wül be found in the thirteenth volume of Virchow's Archives, and in the first volume of the Archives of Medicine, edited by Dr. Beale (p. 344). The following conclusions are arrived at by Kühne as the result of his investigations. 1. In jaundice resulting from closure of the ductus communis choledochus, the urine always contains biliary acid as well as bile- pigment. 2. The presence of biliary acids is a peculiarity of jaundiced urine only. They are never present in normal uriue. 3. The biliary acids are not decomposed in the blood. In what- ever manner they find their way into this fluid, they are afterwards excreted unchanged by the kidneys. Glyco-cholate of soda injected into the veins passes out in the urine unchanged. On the other