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January 2, 1926


JAMA. 1926;86(1):40-41. doi:10.1001/jama.1926.02670270044014

Two significant facts, among others, have contributed to the uncertainty regarding the regulation of the flow of bile: (1) The gallbladder, which has often been assumed to bear some relation to this function, can be removed without untoward effects; and, (2) there are species of animals in which the biliary flow proceeds without reference to any reservoir, since this is normally lacking in them. These circumstances have placed a large burden of participation on the sphincter at the duodenal end of the common bile duct, so far as the discharge of the hepatic secretion into the intestine is concerned. Ever since the description of the sphincter of Oddi, there has been uncertainty as to its influence in the adjustment of biliary flow. This uncertainty is due in part to the indefiniteness of knowledge regarding the anatomy of the structures involved. Even the existence of a distinct anatomic sphincter has been