On loss of weight, blood-spitting and lung disease / by Horace Dobell.

  • Dobell, Horace, 1828-1917.
Date:
1880
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Licence: Public Domain Mark

Credit: On loss of weight, blood-spitting and lung disease / by Horace Dobell. Source: Wellcome Collection.

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    system of those waste products of blood and tissue -which can no longer yield up nutriment or force to the organism. It is a striking fact that all the digestive fluids, from the saliva downwards, promote decomposi- tion until we come to the bile, which, for the first time, reverses the action, and interposes an antiseptic, thus maintaining the status quo of the proceeds of digestion until they are absorbed or cast off as waste, and staying the evolution of gases in the passage of this waste out of the body. In diseases attended with copious expectoration a special importance attaches to the antiseptic properties of bile ; for it is inevitable that a considerable portion, in some cases the whole, of the matter intended for expectoration will pass from the respiratory down the alimentary tract, where it will decompose and act as a septic poison unless this is prevented by some antiseptic agent. I have laid so much stress in other parts of this work upon the vital importance of antiseptic treat- ment in tuberculous blood-poisoning, or tuberculsemia, that I need not do more in this place than call attention to this ,as another reason for promoting a proper flow of normal bile. It is—that large proportion of the bile (about thirty-nine-fortieths) which is reabsorbed—with which we are more especially concerned in considering the question of loss of weight. We cannot fail to be struck with the consideration of how largely the nutrition of the body must be interfered with if, through faulty action of the liver, this enormous daily contribution to the new formative materials of the body is either cut off or ill elaborated, or if, after being duly elaborated and poured into the intestines, it is cast out of the body instead of being absorbed. (See p. 152.) But in addition to the direct supply of nutriment by the action of the liver, the bile has an iudirect influence on nutrition equally im- portant. Not only is its passage into the intestines in some way essential to that formation of Bernardin (amyloid substance or glucogen) out of the carbohydrates, about which I have already spoken, and instrumental in facilitating the digestion of the albuminoid constituents of food; but experiments have shown that the presence of a weak solution of soda or potass in the pores of an animal membrane materially assists the passage through it of emulsionised oil and fat; aud we find in the alkaline bile, diluted with the other digestive fluids, exactly what is wanted to saturate in this manner the lining membrane of the alimentary canal, and thus to facilitate the important process of absorption of fat. There can be no longer any doubt that one of the great purposes of the liver is to assist by these means in the supply of fats to the blood by the lacteal route. It will be recollected that in the course of this work I have again and again pointed out the importance, in all cases of wasting and especially in tuberculosis, of supplying an abundance of carbohydrates