Congenital obliteration (or congenital atresia) of bile-ducts with hepatic cirrhosis / by F. Parkes Weber and G. Dorner.

  • Weber, Frederick Parkes, 1863-1962.
Date:
[1911]
Catalogue details

Licence: In copyright

Credit: Congenital obliteration (or congenital atresia) of bile-ducts with hepatic cirrhosis / by F. Parkes Weber and G. Dorner. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    CONGENITAL OBLITERATION (OR CONGENITAL ATRESIA) OF BILE-DUCTS WITH HEPATIC CIRRHOSIS* By F. Parkes Weber, M.D., F.R.C.P., Physician to the German Hospital, London ; and G. Dorner, M.D., House Physician to the German Hospital. The child, Doris S—, when admitted to the German Hospital on July the 4th, 1910, was four months old, well formed and not emaciated (body-weight 11£ lb. on July the 5th), but rather deeply jaundiced, and showing considerable firm enlargement of both the liver and the spleen; the lower borders of these organs wei*e about half-way between the costal margin and the umbilicus. At that time and until the child’s death no bile entered the intestine, for the faeces (“acholic”) were white and free from urobilin (stercobilin), whereas the urine always contained bile-pigment and gave Gmelin’s reaction for bilirubin, though (by the ordinary tests) it was always free from urobilin and urobilinogen. This would not have been the case had any bile been entering the intestine, since the evidence obtained from experimental work and from clinical and necropsy records is now quite sufficient to prove that when urobilin and urobilinogen are present in the urine there must be some bile (whether from the liver or artificially introduced from without) entering the alimentary canal, whereas if urobilin and urobilinogen are always absent from the urine (and faeces) no bile can be finding its way into the alimentary canal.t The history given was that the jaundice had been noticed soon after birth. We have no information in regard to the colour of the meconium (and the early faeces). At birth the child seems to have had a bullous eruption, from which it recovered under medical treatment in the course of two months. No evidence was obtained * A paper read at the Eoyal Society of Medicine (Section for Disease in Children), November the 25th, 1910. f See Friedrich Midler, ‘ Ueber Icterus,’ 1892; also A. E. Garrod and Gowland Hopkins, ‘ Journ. of Physiol.,’ Cambridge, 189(3, vol. xx, p. 112.