The author tried to investigate the chemical analysis of bile using the infrared absorption spectroscopy to elucidate its component. The biliary specimen, taken by the percutaneous cholangiographic procedure pre-operatively and also during surgery, was lyophilized and examined. The results of 141 cases of cholecystic bile and 18 cases of hepatic bile were proved as follows: 1) The total lyophilized bile was classified into 3 patterns according to its spectroscopic findings. 2) In the type I, it is characterestic that Lecithin Bile Salts System (LBS system), Chloroform fraction by Isaksson's method, occupies to a high extent and extremely coincides with the infrared absorption of the LBS system. 3) In the type II and III, it is characteristic that the bile salts extracted by ethanol and sediment extracted by neither ether, chloroform nor ethanol show the highest ratio and extremely coincide with the infrared absorption respectively. 4) Among the bile, the only type I shows the absorption of 1740cm-1 which is almost due to Lecithin. Experimentally, the infrared absorption spectroscopies were done for the cholecystic bile of normal dogs. 1) The infrared absorption spectrum shows similar pattern which may be due to taurocholate and Lecithin without any body difference. 2) By ligation of cystic and common bile duct, the absorption of 1740cm-1 decreased.
The fundamental studies on the classification of human bile into three patterns according to their qualitative differences with the infrared absorption spectroscopy have been described in previous paper. The author further obtained the following results investigating the clinical correlations between the spectroscopic absorption patterns and the diseases of liver and biliary system. I) Cholecystic bile 1) The contrast cases of twenty patients with gastro-duodenal sufferings showed spectroscopically type I with the rate of 100%, while cholecystitis 65%, cholelithiasis 27% and cancer of biliary system 0%, respectively. Type I seems to be considered as a pattern of normal bile. The ratio of icteric index and solid component of type I-bile is high comparing with type II and type III-bile. 2) The spectroscopic type II and III are considered to be a pattern of pathologic bile and are found in cancer of biliary system with high percentages. 3) Concerning with the relationship to the kinds of stone and the biliary pattern, cholesterin stone showed abnormal finding with the rate of 72%, bilirubine stone with 66%, inorganic stone with 60% and others with 71%. 4) The disturbance of liver function and the dilation of biliary duct are seen mostly in type II and type III, especially remarkable in type II. Thus it seems that the mechanism of obstruction is greatly connected with the change of spectroscopic biliary finding. II) Hepatic bile The hepatic bile, taken by percutaneous cholangiographic puncture pre-operatively, demonstrated type II and type III. Type II is mostly seen in cholelithiasis and cancer in biliary system and type III is all in cancer. Thus, among the possible cases of hepatic bile puncture, many cases of intra-hepatic biliary duct dilatation and the elevated disturbance of liver function were found, especially remarkable with type III. But the relation to the kind of stone is not yet clear.