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September 18, 1897


JAMA. 1897;XXIX(12):599-600. doi:10.1001/jama.1897.02440380041007

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That bile, as secreted by the liver, is not essential to life, is shown by a number of facts, such as obstruction or obliteration of the biliary passages, excision of the liver, biliary fistulæ, etc. Whether under these circumstances the functions of the bile are replaced or compensated for by the activity of some other organ or organs, is not known. It has been thought that suppression of the biliary secretion results in two groups of symptoms: Those of cholemia, arising from the retention of bile in the liver and its resorption into the blood; and those of acholia, arising from the absence of bile from the intestinal tract. These symptoms will be the more pronounced in accordance with the abruptness of their onset and it is possible, under certain conditions, that they may lead to a fatal issue. Gradually induced, however, the system seems capable of adapting itself to

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