THE ELIMINATION OF CHOLIC ACIDS. IV. IN PATIENTS WITH LIVER DISEASES 1

Abstract

The elimination of cholic acids was studied in patients with and without liver diseases. 0.5 g. acid in the form of 0.52% sodium cholate in 25% glucose soln. were injected intraven. Blood samples drawn before and 5, 30 and 60 mins. after the inj. were analyzed by the modified Josephson method. Normally most of the injected cholate had disappeared after 5 mins. and conc. in the blood was normal after 30 mins. In jaundice, the increase was higher after inj. In obstructive jaundice the subsequent decrease was more rapid than in hepatitis. The difference between the 5 and 30 min. values exceeded 2 mg per 100 ml in obstruction and was less than 1 mg per 100 ml in hepatitis. The possibility of using this difference for diagnostic purposes is discussed. In some cases the 60 min. value showed a slight increase compared with the 30 min. value, probably due to a leakage of bile salts to the blood through the lymph vessels of the liver. The elimination was normal in patients with liver diseases without jaundice.