An experimental study of the hydrogen-ion concentration and chemistry of bile, its effect upon stones, and a suggestion as to therapeutic application of ox-bile in gall bladder disease

Abstract

1. In a study of gall bladder bile of different species one of the most striking features is the apparent immutability of its characteristic hydrogenion concentration. 2. The pH of bile does not readily change following various forms of therapy. 3. It is our belief that various foods do not significantly alter the pH of gall bladder bile. 4. The feeding of large doses of powdered extract ox-bile U. S. P. changes the dog’s normal acidic bile to alkaline and also dilutes the chemical constituents. Feeding of smaller doses does not change the pH of gall bladder bile in the dog nor does it have any diluting effect. 5. The feeding of keto bile acids (0.7 gram per day) did not change the pH of gall bladder bile in the dog nor did it bring about as great a dissolution of the stones as is noted in the normal and ox-bile fed animal. This dosage of keto bile acids approximated the human dose. The diluting effect was much less marked than in feeding large doses of ox-bile. 6. The pH of bile is not the sole criterion in the dissolution of gall stones, as is demonstrated by the fact that even though large doses of ox-bile change the pH of dog’s acidic gall bladder bile to the alkaline side, they do not significantly influence the degree of dissolution of implanted human cholesterol stones. In our opinion, the dissolution of the stones by the alkaline bile after the feeding of large quantities of ox-bile, is due to its cholagogue effect.