In this study of fat metabolism, with a consideration of the nitrogen balance in a case of congenital absence of the bile-ducts, we were especially concerned from a clinical standpoint, not only with the fat and nitrogen disposition in the body, but with the activity of the pancreatic ferments. In this, one of us (Koplik) was fortunate in having the active co-operation of a colleague skilled in studies of such a nature.
From a clinical standpoint it is of importance to ascertain whether the ducts are stenosed or absent, or practically occluded. There are cases of stenosis of the bile-ducts in which considerable bile passes into the intestine; such a case we have seen lately. In this case also there was the anomaly of a very large colon (Hirschsprung). In such a case metabolism studies would be of uncertain value on account of the abnormal state of the large, or