That the bile is altered as a result of disease was noticed by Tacconi1 as far back as 1740. He remarked that in fever the bile changes in color and taste. Tacconi's observations were very few and superficial. Much more accurate were the studies of Uffelmann2 on the subject, carried out in 1874. He had the good fortune to make observations on the flow of bile from a patient with a biliary fistula who had an attack of pneumonia and noticed that the secretion of bile ceased with the onset of the disease. The same patient was later taken sick with dysentery. Again there was a disturbance of the activity of the liver. The secretion of bile almost stopped, he reported, with the manifestation of the disease.
Similar observations on the human subject were made more recently by Noel Paton and J. M. Balfour.3 About ten weeks