It seems plausible that the decrease in the capacity of the liver to concentrate bile acids (taurocholic and glycocholic acids and their salts) in the bile should be an index to the amount of hepatic damage present. Bollman and Mann1 have shown that bile acids are produced, destroyed and concentrated in and only by the liver. Smyth and Whipple,2 as well as Bollman and Mann, have shown that small doses of substances known to be hepatotoxins, that is, chloroform, carbon tetrachloride and tetrachlorethylene, inhibit the function of the liver of the dog in producing and concentrating bile acids. Walters, Greene, and Frederickson3 studied the constituents of the bile of a series of patients who had been operated on for biliary disease. They noticed that a decrease in the concentration of bile acids in the bile followed operations on the biliary system. Mann and two of us (McGowan
GRAY HK, McGOWAN JM, NETTROUR WS, BOLLMAN JL. HEPATIC DAMAGE IN BILIARY DISEASE: ITS RELATION TO THE CONCENTRATION OF BILE ACIDS IN THE BILE. Arch Surg. 1938;37(5):790–799. doi:10.1001/archsurg.1938.01200050096007
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