FEL BOVINUffl 
AS A 
Therapeutic Agent. 
BY ' 
D. li. M. D. Reprint from “THE AMERICAN THERAPIST,” 
January, 1893. 
EEL BOVINUM AS A THERAPEUTIC 
AGENT 
D. H. Bergey, M. D. 
The employment of ox-gall in medicine 
is not of recent date. It was in general 
use more than fifty years ago, and con- 
tinuously, to a greater or less extent, ever 
since. Writers of fifty years ago have 
more to say with regard to its value as a 
therapeutic agent than those of any other 
period, with the exception of the last three 
or four years. 
Pareira says1 “It was formerly em- 
ployed as a tonic, and it has been recently 
re-introduced by a few practitioners in dys- 
peptic cases and biliary derangement.” 
Wood and Bache* speak of its use in 
cases of deficient biliary secretion; also 
of its use as a tonic and laxative. Dun- 
glison* refers to its use as a “detergent, 
*) Elements of Materia Medica and Therapeu- 
tics, 3d ed., 1854, p. 1169. 
*) National Dispensatory, 1849, p. 1292. - 
3) Medical Dictionary, i860. 2 
anti-otalgic and emmenagogue,” as well 
as its reputed power of facilitating labor. 
“It has also been given as a bitter stom- 
achic and anthelmintic, as a tonic and 
laxative in cases of deficiency of biliary 
secretion.” Naphey4 says, “when there 
is torpidity of the liver and deficiency of 
the biliary secretion it may prove useful 
by supplying the deficiency.” Farquarson6 
says, “Bile is well known to act as a 
laxative, to aid the digestion of fatty and 
amylaceous consiituents of our diet, and 
to prevent the decomposition of food within 
the intestines.” He speaks of its use in 
dyspepsia and chronic diarrhea. H. V. 
Severinger" gives the chemical constit- 
uents of bile, and speaks of its use in med- 
icine. The U. S. Dispensatory7 says, 
“Along with pancreatic juice, bile neutral- 
izes the acidity of the chyme,"and emul- 
sifies fatty matters. The excess of it tends 
to quicken the peristaltic movements of 
the bowels. Profuse secretion,of it pro- 
duces diarrhea, deficient secretion consti- 
pation. It prevents fermentative and pu- 
■*) Modern Medical Therapeutics, 1878, p. 316. 
») Guide to Therapeutics and Materia Medica, 
1882, p. 457- 
6) Dictionary of Pharmaceutical Science, 1882. 
7) U. S. Dispensatory, 1880. 3 
trefactive decomposition of the food, aids 
in the solution of fatty matters, promotes 
peristaltic action of the intestines, and in 
sufficient dose purges.” It speaks of its 
use in habitual constipation, in atony of 
the bowels, the bowel not being so apt to 
become torpid as after purgatives ; in dys- 
peptic derangements caused by engorged 
colon and consequent compression of the 
liver; in jaundice from catarrh of the bile 
ducts; as a vermifuge for lumbricoides; 
in glandular hypertrophies as a topical 
agent. Waring8 says it is “not a pur- 
gative, but acts simply as a solvent of ma- 
terials contained in the stomach and intes- 
tinal canal, producing no excitement to 
propel, but, by liquifying the mass, facili- 
tates its excretion.” He also speaks of its 
therapeutic uses in dyspepsia and consti- 
pation attended by torpor of the liver, 
when the stools indicate deficiency of bil- 
iary secretion ; in jaundice with obstruc- 
tion ; in functional disorder of the liver; 
mesenteric affections; hypochondriasis 
with dyspepsia. 
Porter9 speaks at length of the action 
of bile in the human economy. First, its 
8) Practical Therapeutics, 4th ed., 1886, p. 265. 
9) The Medical News, January 10 and 24, and 
February 28, 1891. 4 
emulsifying action upon the neutral fats 
in our food ; the action of converting the 
unconverted starch into glucose; its stim- 
ulant action as a whole in producing peris- 
talsis of the intestines, thus tending to 
favor absorption and prevent constipa- 
tion; the stimulant action of the bile acids 
upon the small muscles in the villi of the 
intestines, so that by the contraction of 
these muscles the contents of the lymph- 
spaces are carried toward the larger lymph- 
atics, leaving those of the villi in a posi- 
tion to absorb more; its valuable function 
in accelerating the osmosis of nutrient 
particles, and in stimulating the onward 
movement of the contents of the intes- 
tines; its anti-fermentative action, whereby 
it may be looked upon as being “Nature’s 
chief antiseptic;” and lastly, its undoubted 
office to maintain the full nutrition of the 
body by maintaining active digestion and 
assimilation. 
Sufficient has already been said as to the 
value and uses of ox-gall as a therapeutic 
agent to preclude the need of any apol- 
ogy for again calling the attention of phy- 
sicians to its claims for place in their ar- 
mamentarium. 
Ox-gall is a viscid fluid, of greenish or 
greenish-yellow color, a peculiar nauseous 5 
odor, and a bitter taste. The U. S. Dis- 
pensatory, 1880, gives the following con- 
stituents: Bilirubin, C16H16NaOs; bilifuscin, 
a dark, olive-brown powder; biliprasin, a 
greenish-black powder; bilihumin, a black- 
ish powder; biliverdin (oxidation of bili- 
rubin), a dark-green powder; cholestrin, 
C„,H440. It also contains 3 per cent, of 
glycocholic acid, Ca„H4sNO„ and 3 per 
cent, of taurocholic acid, C3llH45NS07. Its 
composition is exceedingly complex, and 
it is impossible to determine the exact phy- 
siological properties of each of the con- 
stituents. 
As a laxative, in normal conditions of 
the intestinal tract, its action is unques- 
tioned. Excessive secretions of bile are 
invariably followed by copious movements 
of the bowels with, frequently, severe grip- 
ing pains; while deficiency of secretion is 
invariably followed by obstinate consti- 
pation, which is only fully relieved by 
establishing a free flow of bile. That ox- 
gall has practically identical effects in the 
human system has been repeatedly de- 
monstrated. The consensus of opinion 
on this point is so general that further facts 
to prove it are uncalled for. 
Bearing in mind the physiological offices 
of bile we have a direct indication of the 6 
functions which we may expect this med- 
icament to perform, and the pathological 
conditions under which we may hope to 
obtain satisfactory results from its use. 
In all those conditions where we have a 
deficient flow of bil.e, whatever the cause, 
we may confidently expect to alleviate the 
more distressing symptoms, if not lay the 
foundations for speedy and complete re- 
covery. In constipation, especially the 
chronic form with atony of the colon, it is 
of undoubted value in many cases. It 
acts as a stomachic and stimulates the 
appetite; it assists in dissolving and emul- 
sifying the fatty materials of the food; it 
increases the peristaltic movements of the 
intestines, and thus facilitates the excre- 
tion of effete matters; and it assists in the 
osmosis of the nutrient particles of the food, 
and thereby greatly accelerates their assim- 
ilation. In catarrhal conditions of the in- 
testinal tract, and especially in colitis and 
dysentery, it has distinct and important 
functions. It not only facilitates the solu- 
tion of the food and accelerates the on- 
ward movement of excretory products, 
but it acts as an anti-putrefactive agent, 
and thus prevents the deleterious effect of 
the action of micro-organisms in this con- 
dition. In fecal impaction it is a powerful 7 
agent in the relief of flatulence, and in 
stimulating the movements of the rectum 
and colon to expel the impacted feces. In 
torpidity of the liver and jaundice from 
obstruction, its influence as a solvent 
makes it no uncertain agent. For more 
than a year past I have repeatedly made 
use of it in cases of this nature, of which 
an unusual number have been under my 
treatment since the late epidemic of influ- 
enza, and the relief has been marked in a 
large percentage of the cases. They present 
themselves with more or less marked con- 
stipation, sometimes alternating with di- 
arrhea of several hours duration, and ac- 
companied with severe, griping pains; 
many have marked jaundice, and all have 
impaired or depraved appetite. In these 
cases ox-gall has had a good influence in 
arousing the torpid liver, and in dissolv- 
ing the bile-salts lodged within the tissues, 
and in facilitating their excretion. 
The value of this remedial agent is not, 
however, to be overrated. The indications 
for its use must be positive. It must be 
accompanied with intelligent hygienic 
measures. Many other drugs can be ad- 
vantageously combined with it. In the 
diseases of the intestinal tract pancreatic 
juice is sometimes as strongly indicated 8 
as ox-gall, and is therefore equally neces- 
sary. In chronic constipation strychnine 
may be combined with it with good effect, 
and it is well to have the intestinal tract 
unloaded with some active cathartic. In 
torpidity of the liver one of the salts of 
mercury is equally useful when thus com- 
bined with it. 
It is preferable, on account of its bitter 
taste and nauseous odor, to administer it 
in capsules or in pill form. I have, how- 
ever, frequently administered it in solu- 
tion, disguised as much as possible, with- 
out any complaint from my patients. It 
is best, for continuous use, to administer 
ox-gall in doses of two grains ; though as 
much as five and even ten grains may be 
given in some cases without the laxative 
effect becoming too pronounced. It is pre- 
ferable to administer it a short time before 
meals, in order that it may readily pass 
the pylorus into the intestine. 
North Wales, Penn. The • • 
American Therapist. 
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