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CLINICAL OBSERVATIONS ON CERTAIN CONSTITUENTS OF THE BILE

REGINALD FITZ, M.D.; MARTHA ALDRICH, B.A.
JAMA. 1922;79(26):2129-2132. doi:10.1001/jama.1922.02640260001001.
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In 1919, Lyon1 described a relatively simple clinical method for the diagnosis and treatment of diseases of the gallbladder and biliary ducts. This, in brief, consisted in the drainage of the biliary tract through a duodenal tube after relaxation of the sphincter of Oddi by the local application to the duodenum of a concentrated solution of magnesium sulphate. The method was based on a suggestion from Meltzer2 that magnesium sulphate might relax the sphincter of the common duct and permit the ejection of bile into the duodenum. By making use of this procedure, Lyon believed that he could collect separately bile from the common duct, the gallbladder and the hepatic ducts, and could study each sample chemically, bacteriologically and cytologically. The potential importance of Lyon's work was immediately recognized, and already a large and somewhat conflicting literature on the so-called Meltzer-Lyon test has accumulated. Certain observers, notably Brown,

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