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Healthy Bile: A Functional Medicine, Ayurveda, and TCM Integrated Approach

The curious aspect of bile is that it has a medical lineage dating back to ancient civilizations. From the ancient Greeks to the 1800s, medicine was highly influenced by a concept known as the humoral theory of health. Tracing back to Hippocrates and Galen, and possibly earlier, it was thought there were four bodily humors a particular temperament was associated with: phlegm (phlegmatic), blood (sanguine), yellow bile (choleric), and black bile (melancholic). Disease, both physical and mental, was attributed to an imbalance of humors. Although modern medicine and psychology may have advanced beyond the humors, the impact on culture and language remains, but the recognition of bile within medicine,…

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Articles of Interest

A history of research into the physiology of bile, from Hippocrates to molecular medicine

It was therefore logical to the physician of old that bile should play an important role in physical health, as well as in mood and temperament—that is, a “proportioned mixture of elements,” from Latin temperare to control or blend together the four qualities: hot, cold, moist, and dry. A mainstay of the disciples or school of Hippocrates (c.460–c.377 BCE; was the humoral theory of diseases, a concept that originated with the Pythagoreans two centuries earlier.

A Medieval Cow Bile Stew Could Teach Us How to Fight Modern Infections

The formula in the 10th century medical text, called “Bald’s Leechbook,” involves mixing garlic, onion, wine, and cow bile in a brass vessel before letting the mixture sit for nine days to ferment. The resulting concoction, brewed up by the researchers in a modern glass container with a brass square placed in it to replicated a brass vessel, proved 90 percent effective in killing MRSA in laboratory testing, says Kendra Rumbaugh, a professor at Texas Tech University Health Sciences Center.

Bile Acid Physiology

The primary bile acids (BAs) are synthetized from cholesterol in the liver, conjugated to glycine or taurine to increase their solubility, secreted into bile, concentrated in the gallbladder during fasting, and expelled in the intestine in response to dietary fat. BAs are also bio-transformed in the colon to the secondary BAs by the gut microbiota, reabsorbed in the ileum and colon back to the liver, and minimally lost in the feces.

Bile acids might tip microbiome in healthy direction

Every time we eat, the gallbladder—a small pouch located just below the liver—releases a bit of fluid known as bile into our small intestine to help break down the fat we consume. That bile contains water, electrolytes and several organic molecules including cholesterol and bile acid. Scientists now have pinpointed a gene linked to the movement of bile acid in the body that might affect the abundance and influence of different microorganisms in our guts.

Bile Acids—A Peek Into Their History and Signaling

Bile acids wear many hats, including those of an emulsifier to facilitate nutrient absorption, a cholesterol metabolite, and a signaling molecule in various tissues modulating itching to metabolism and cellular functions. Bile acids are synthesized in the liver but exhibit wide-ranging effects indicating their ability to mediate organ-organ crosstalk. So, how does a steroid metabolite orchestrate such diverse functions?

Bile: What it is and why you need it

Around 1,000 years ago, the humoral theory of medicine was born. It stated that to maintain good health, your four “humors” needed to be properly balanced. Those four humors were phlegm, yellow bile, black bile, and blood. And the theory persisted for centuries. People believed that if you had too much or too little of these compounds in your system, you'd likely have problems. For instance, if you were seen as overly angry, people might attribute it to an excess of yellow bile. Still today, if someone says you’re “full of bile,” it means you’re full of anger. It won’t surprise you to learn that doctors no longer follow these guidelines.

Blood in Pop Culture: Blood Running Cold? Check Your Black Bile!

While this understanding of the human body clearly fell out of favor in medicine and culture long ago, its legacy lives on in our vocabulary. So, next time you think of someone’s blood running cold, you might want to tip your hat to Aristotle and to our cold, dry friend, black bile.

Blood in Pop Culture: Blood Running Cold? Check Your Black Bile!

While this understanding of the human body clearly fell out of favor in medicine and culture long ago, its legacy lives on in our vocabulary. So, next time you think of someone’s blood running cold, you might want to tip your hat to Aristotle and to our cold, dry friend, black bile.

From Hypo to Bile

This chapter elucidates the ways that biliousness, a new fashionable somatic disease of bile, developed out of, and was differentiated from, the older fashionable nervous disease of hypochondria or ‘Hypo’ in the long eighteenth century. Biliousness became not only fashionable in the late eighteenth century but also a mania in the Regency period.

Significance of Bile

Bile, as explored across various traditions and fields, is a significant fluid produced by the liver. In Tibetan Buddhism, it is not directly linked to hatred, while in Ayurveda, it plays a crucial role related to jaundice and digestion. Purana and Jyotisha emphasize its relevance in health contexts, particularly around imbalances. It is classified among humors/doshas in Ayurvedic practices, associated with illnesses, and studied in science for its role in digestion and inflammation. Overall, bile is essential for various bodily functions and health perspectives.

The Damage of Reflux (Bile, Not Acid)

Misdiagnosis of bile reflux and failure to control it can result in serious, sometimes life-threatening problems — stomach ulcers that bleed and Barrett’s esophagus, a possible precursor to esophageal cancer. Yet misdiagnosis is common, and even when the condition is properly identified, doctors are often fatalistic about its management.

The Role of Bile Acids in Digestion and Pancreatic Cancer

Beyond aiding in the digestion of fats, bile acids also serve to eliminate cholesterol, which is otherwise insoluble in water. However, the acids and lipids in bile work to break up cholesterol molecules. There are also several types of bile acids and bile salts that form during digestive functions. (List some of them) And because these substances are changing through digestion, most of them are actually reabsorbed into the bloodstream and reincorporated into the digestive system.

“And there's the humor of it” Shakespeare and The Four Humors

Yet Shakespeare understood human personality in the terms available to his age—that of the now—discarded theory of the four bodily humors—blood, bile, melancholy, and phlegm. These four humors were understood to define peoples’ physical and mental health, and determined their personality, as well.

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StatPearls

Bile is a fundamental and unique secretion of the liver. It is a yellow-greenish fluid secreted from the hepatocytes and altered as it passes through the biliary tree by the epithelial cells lining the bile duct (cholangiocytes). After its secretion, bile is stored and concentrated in the gallbladder. Lipids in the duodenum stimulate the release of cholecystokinin, which stimulates gallbladder wall contraction, resulting in the release of bile into the cystic and common bile duct.