. Annals of surgery. abscess was opened. On post-mortem examination I found that the hard tumor underthe abscess was formed by the right lobe of the liver with mattedomentum and intestines. In the centre of the hard mass there was acavity containing a small quantity of pus and two gall-stones. Partof the wall of the cavity was formed by the remains of the ruptured,suppurating gall-bladder. This case is recorded with the object of emphasizing my ideathat death is a not uncommon result of gall-stone. Remarks.—It is a generally accepted belief, and one based13 194 RUTHERFORD MORIS ON. upon suffic
. Annals of surgery. abscess was opened. On post-mortem examination I found that the hard tumor underthe abscess was formed by the right lobe of the liver with mattedomentum and intestines. In the centre of the hard mass there was acavity containing a small quantity of pus and two gall-stones. Partof the wall of the cavity was formed by the remains of the ruptured,suppurating gall-bladder. This case is recorded with the object of emphasizing my ideathat death is a not uncommon result of gall-stone. Remarks.—It is a generally accepted belief, and one based13 194 RUTHERFORD MORIS ON. upon sufficient evidence, that gall-stones are formed in the greatmajority of cases in the gall-bladder. Mucus seems to be essential to their formation, and this isonly secreted by the gall-bladder and the larger ducts. The cir-culation in the larger ducts is so constant that deposition of saltsand inspissation of bile would be difficult there, but in the gall-bladder the relative stagnation and other conditions are favorable. Fig. 3.—The pouch described shown by drawing liverupward. X ^^ ^^ figures marks points fordrainage. to gall-Stone formation. Though gall-stones are frequently foundin the smaller ducts, it does not follow that they are formed is not difficult to believe that they are carried and deposited bya back flow of bile, which must be of common occurrence in thecomplicated biliary circulation. Symptoms.—There can be no doubt but that gall-stones arefrequently present in the gall-bladder, without causing symptoms ON GALL-STONES. 195 that something more than the mere presence of the stones isnecessary to excite an attack of coHc. The same is true of urinary calcuH. A renal or a vesicalcalculus (especially oxalate of lime) may be present for years
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
