Bile

“ If bile be administered, as I propose, at the end of stomachal digestion, it will, as in the healthy organism, act on the chyme at the proper moment, and thereby render it fit for absorption. In order still further to ensure the action of the bile being delayed until the food is in a condition favourable to its action, that is to say, until it is ready to pass from the stomach into the duodenum, I have had the bile, as above prepared, put into capsules,31 which are not readily acted on by the gastric juice. ”

“ Bile is the first digestive agent with which the food comes in contact on leaving the stomach and entering the intestines, and immediately on the acid chyme mixing with the alkaline bile, a white flocculent emulsion is formed, which emulsion has been described by many writers as a precipitation of the albuminose (digested albumen) . Later [p. 15] researches by myself and others have, however, shown that it is not the bile which precipitates the albuminose, but the acid of the chyme, which in reality sets free certain ingredients of the alkaline bile. ”

“ The saliva aids the stomach by stimulating its glands to make gastric juice. The gastric juice and the bile are excellent antiseptics, by which the food is preserved from fermentation while undergoing digestion. The bile also stimulates the movements of the intestines by which the food is moved along, and aids absorption. It is remarkable and interesting that a fluid so useful as the bile should be at the same time composed of waste matters which are being removed from the body. This is an illustration of the wonderful economy shown by nature in her operations. ”

“ Such waste materials as the liver cannot burn down so that the kidneys and skin can handle them, it pours out through its duct into the intestine as the bile. The bile is a yellowish-brown fluid, which assists the pancreatic juice in the digestion of the food, and helps to dissolve the fats eaten, but is chiefly a waste product. It turns green when it has been acted upon by acids, or exposed to the air. So that the bile which you throw up when you are very sick at your stomach, is green because it has been acted upon by your gastric juice. ”

“ Caffres drink bile direct from the gall-bladders of the animals killed by the European party, and that, while passing the gall-bladder round to each other, they would rub their stomachs and say,—"Mooé-ka-kolla," signifying thereby, that it was very good. It certainly seems very extraordinary that any human being should not only drink, but drink with pleasure, a liquid so bitter and nauseating as bile. ”

“ Our whole energies should be directed to sustaining the strength of the patient, and mitigating, if possible, the physical effects of the accumulation of the bile in the gall-bladder and biliary ducts, as well as the poisonous action of the re-absorbed secretion. This, I believe, we can best do by administering light and readily digested food, keeping the bowels open by gentle purgatives, and favouring the elimination of the biliary constituents from the blood by mild diuretics. ”

“ But if the atony arise from a hot intemperament, in process of time it appears more feculent and very fetid, the bile being high-coloured and thick. Wherefore, the substance of the liver being already melted, the whole body also is melted down; and there is fever, anorexia, and vomiting of bile. When the intemperament is cold, the discharges are neither constant nor many, for the affection is a chronic one; and for several days the discharges from the belly will be more abundant, but less fetid, like the lees of thick blood, approaching to black bile. ”

“ There is reason to believe, that the bile is most frequently returned into the circulation by the inverted motions of these hepatic glands, for the bile does not seem liable to be absorbed by the lymphatics, for it soaks through the gall-ducts, and is frequently found in the cellular membrane. This kind of jaundice is not generally attended with pain, neither at the extremity of the bile-duct, where it enters the duodenum, nor on the region of the gall-bladder. ”

“ The excretion of bile is greatly aided by the pressure which is exerted upon it by the movements of the diaphragm during respiration, and indeed so low is the pressure under which the bile is secreted that, but for the assistance given by the respiratory movement, it would just barely find its way into the duodenum. Although we are accustomed to say "as bitter as gall," according to my own observations fresh human bile is not bitter. When it is thrown up in consequence of indigestion it is intensely bitter. ”

“ One of the effects of the bile in this operation is to extinguish acidity, whether proceeding from substances taken in, or generated in the stomach. The blood in all climates, and in all situations of life, is subject to have part of it thus corrupted, which, being separated from the common mass by the liver, is mingled and discharged with the common feces; but external heat continued for any length of time tends to augment this corruption of the fluids, and therefore to increase the secretion of bile ”

“ The minute cells of the liver have individual work to perform in separating nutritive matter from waste; and, unless care be taken to furnish a food supply correct in proportion and quality, bile is secreted in amount larger than the system demands or requires, and is itself absorbed and reabsorbed, with additions from other sources, until congestion results, the circulation is vitiated, and the bowels are filled with bilious toxins that poison and re-poison indefinitely. ”

“ The pain increases as the day advances, till at last something sets in, and a quantity of bile is discharged from the stomach. Though the attack is most distressing, and makes one very miserable while it lasts, I don’t know but it is worth going through and enduring, for the sake of the delightful feelings of renewed health and spirits one experiences next day, when all the bile is out of the system. One is always conscious of the approach of an attack, and it can be warded off by a dose of medicine—pills, castor oil, anything in short that will thoroughly move the bowels. ”

“ It is true that after a "bilious" person has vomited for a few minutes he is likely to throw up a certain amount of bile, which is supposed to have been lying in his stomach and causing the nausea. In fact, however, this bile is merely a part of the usual supply stored away in the gall-bladder. By the very act of retching, the bile is forced out of the bile channels into the stomach and thence up into the mouth. Anybody can throw up bile at any time if he only tries hard enough. ”

“ When the liver is inactive, we have what is called the jaundice; the liver failing to take up from the system that substance which forms the bile. When this is the case, a yellow substance is found diffused throughout the whole body, and it exhibits a yellow tinge. The bile, when properly secreted and discharged, meets the contents of the stomach as discharged into that part of the bowels nearest the stomach, and is there supposed to assist in the process of separating the nutritious part of the contents from the refuse, which is to pass off by the bowels ”

“ In Yellow Fever, and in several other diseases, the bile which is brought up by vomiting is frequently of a vivid green colour, and some writers have attributed the phenomenon to a morbid condition, or action of the liver or gall bladder; the fact however is, that the bile itself undergoes a chemical change in the Duodenum and Stomach. That bile does undergo such a change from decomposition, is proved by a variety of facts observed to take place out of the body ”

“ A woman will complain of being bilious; there may be a bitter taste in the mouth, a burning in the throat, frontal headache, nausea, and even vomiting, the urine high-colored, the bile abounding in the alvine dejections, and perhaps causing heat and a stinging sensation in the rectum; the tongue furred, a biliary tinge pervading the cutaneous surface." The propriety of ascribing the symptoms so graphically described in these words to excess, deficiency, or vitiation of the biliary secretion, in the entire absence of precise knowledge, may well be questioned. ”

“ The continued operation of this cause maintains an abnormal activity of the liver, and more bile is produced than is easily disposed of.
SYMPTOMS.—The condition of biliousness, as now understood, is made up of derangement of the gastro-duodenal mucous membrane, with bile-production in excess and bile-absorption probably delayed. The symptoms are the product of these complicated conditions. The complexion is muddy; the conjunctivæ are yellow; the tongue is heavily coated with a yellowish-white fur; a bitter taste persists in the mouth; the breath is heavy in odor, even fetid ”

“ He proved that bile, which used to be considered an excretion, was really an important digestive secretion. He was not able to demonstrate the function of bile as completely as he had done for the gastric juice. The problem of intestinal digestion is much more complicated than that of stomach digestion, and involves a number of factors for which allowance has to be made if the value of any one of them is to be accurately determined. Even in our own day all of the physiological problems in the functions of biliary secretion are not solved. ”

“ Hence, in sea-sickness for example, the first fits of retching generally bring up nothing but food or mucus—the real contents of the stomach,—and it is only after continued straining that bitter bile makes its appearance. In the healthy state, fat or oily food often causes the presence of bile in the stomach, as if its aid were necessary there for the accomplishment of digestion. ”

“ Rapid Relief From Colon Cleansing
During fasting the liver is hard at work processing toxins released from fat and other body deposits. The liver still dumps its wastes into the intestines through the bile duct. While eating normally, bile, which contains highly toxic substances, is passed through the intestines and is eliminated before too much is reabsorbed. (It is the bile that usually makes the fecal matter so dark in color.) However, reduction of food bulk reduces or completely eliminates peristalsis, thus allowing intestinal contents to sit for extended periods. ”

“ Treatment is dietetic in character and is directed toward relieving or preventing inflammation in the bile passages, also in stimulating the flow of bile in order that it may not become sluggish and thus give rise to the development of the gallstones.
The Fats, therefore must be restricted in the diet, as they, more than any of the other food constituents, favor the above conditions.
Peristalsis in the intestinal tract must be stimulated to facilitate a free flow of bile, which will not occur where the movements are sluggish. Stasis of the bile must be prevented or stones will be apt to form. ”

“ These cases show conclusively, that the matter of the black vomit, occurring in yellow fever, should not be regarded as altered bile; and that the supposition of its consisting of a secretion of the mucous membrane of the stomach, does not rest on a much more solid foundation. For bile can hardly be admitted to exude from the skin and serous membranes, and we cannot suppose, that fluids, similar in every respect, can be secreted from two surfaces, so very distinct in their organization, and in the nature of their ordinary products, as those of the mucous and serous membranes. ”

“ Bile is a strongly alkaline fluid of greenish color. It reaches the intestine through [Pg 307] the same opening as the pancreatic fluid. Almost one quart of bile is passed daily into the digestive canal. The color of bile is due to certain waste substances which come from the destruction of worn-out red corpuscles of the blood. This destruction takes place in the liver.
Diagram of a bit of the wall of the small intestine, greatly magnified, a, mouths of intestinal glands; b, villus cut lengthwise to show blood vessels and lacteal (in center) ; e, lacteal sending branches to other villi ”

“ Bile is hot and dry, but no general account can be given of its properties, as almost that of every animal differs from another. If goat’s bile be used, it will relieve an affection of the liver, and if it be mixed with camphor and butter, and introduced into the ear, it will cure tooth-ache, or rubbed into the abdomen of a child below the navel, it will prove laxative. Cow’s bile, if introduced into the ear, will cure pain arising from wind, mucus or bile. ”

“ That the ready flow or free outlet of bile is the natural and proper medium of relief in such cases, every one has an opportunity to judge; for fits of anger are so common in Lima, that a day never passes without witnessing or hearing of their ill consequences; and the most familiar and immediate effect is a [87] bilious disorder of the bowels, or indigestion and subsequent vomiting,—just as the stomach happens to be occupied, or otherwise, during the period of mental perturbation. ”

“ The bile that we bring up at the end of these interesting acrobatic performances and which makes us feel so much better,—because we have now got the cause of the trouble out of our system,—is simply due to the prolonged vomiting, which has reversed the normal current and caused the perfectly healthy bile from our unoffending liver to pass upward into the stomach, instead of downward into the bowels. ”