Studies on Gall Bladder Function Viii. the Fate of Bile Pigment and Cholesterol in Hepatic Bile Subjected to Gall Bladder Activity by Cecilia

Eleven years have passed since Rous and McMaster (15) published their paper on the concentrating activity of the gall bladder. This contribution and subsequent ones by them and their associates renewed the interest of investigators in this organ. Two schools have developed, each with a different fundamental concept of gall bladder function. The one, following what would appear to be the more logical concept, maintains that concentrated bile is emptied at intervals into the duodenum. The other, largely from teleological reasoning, believes that the cystic duct is a one-way tube, permitting hepatic bile to flow into the gall bladder, but preventing it from flowing out. Those who accept the latter concept must necessarily adhere to the theory that every constituent of the bile is absorbed through the gall bladder wall. If the latter group is correct there must be an optimum concentration for "different constituents of the bile at which level they are absorbed at a definite rate. The experiments of Rous and McMaster indicated that bile pigment was not absorbed through the gall bladder wall. If this is true, and if the gall bladder has no other way of evacuating itself except by absorption, it would not take long for the lumen to be filled with an inspissated mass of pigment. The experiments on the pigment changes of hepatic bile subjected to gall bladder activity were open to certain errors which Rous and McMaster duly considered. The experiments were not absolutely quantitative in that the amountof hepatic bile entering the gall bladder could not be absolutely measured.