Behavior of Human Gall-Bladder During Fasting and in Response to Food.

Abstract

In a recent paper by the author, 1 roentgenological evidence from patients and experimental animals was presented in support of the following conclusions: (1) the mammalian gall bladder, at least in man and in cats, is able to expel all its fluid contents by the contraction of its musculature; (2) after meals this contraction is so timed as to meet the first requirements of digestion—in contrast to hepatic secretion which is designed to meet later needs; (3) in cats the gall bladder responds to such changes in the circulation as are produced by blood transfusions and to such superficial lesions as are caused by shaving and by cutaneous incisions; (4) adrenalin (with its implication of the sympathetic nervous system) is the most powerful excitant of gall bladder contraction yet found.

One of the methods employed was the making of long series of human cholecystograms at 15-minute intervals after meals. In such series it was found that the first X-rays after food showed changes in shape of the human gall bladder which could be interpreted as due only to muscle contraction. In two new series (with Dr. L. O. Morgan as the subject) this fact has been even more strikingly brought out than before (15' pc., Figs. 1 and 2). During the first 240 minutes (Fig. 2) the gall bladder assumed the shape of a flaccid organ, subject to distortion by external pressure. Fifteen minutes after ingestion of cream the wall tightened and there was revealed an actual expulsion of iodized bile into the cystic duct. During the preceding period of fasting, however, there occurred one marked contraction (100', Fig. 2), as a result of which the volume of the gall bladder shrank from 4.15 cubic inches to 2.17 (for method of calculation, see former paper).