. Annual and analytical cyclopaedia of practical medicine . the first casebiliary colic without jaundice is usuallypresent, and in the latter colic withjaundice. It must, however, l)e remem-bered that a calculus may pass throughinto the duodenum without pain or anyother disturbance. This usually hap-pens when the ducts have been widenedby the passage of stones previously. Bilianj Colic. — Premonitory symp-toms—such as those of dyspepsia, a feel-ing of weight and distress with greatrestlessness—may be present. The onsetis usually sudden: a severe paroxysmalpain is experienced in the gall-bladde
. Annual and analytical cyclopaedia of practical medicine . the first casebiliary colic without jaundice is usuallypresent, and in the latter colic withjaundice. It must, however, l)e remem-bered that a calculus may pass throughinto the duodenum without pain or anyother disturbance. This usually hap-pens when the ducts have been widenedby the passage of stones previously. Bilianj Colic. — Premonitory symp-toms—such as those of dyspepsia, a feel-ing of weight and distress with greatrestlessness—may be present. The onsetis usually sudden: a severe paroxysmalpain is experienced in the gall-bladderregion, radiating upward to the right or 186 CHOLELITHIASIS. SYMPTOMS. left shoulder, across or down the ab-domen to the thighs. The pain is parox-ysmal and increases in severity until itreaches a climax. The patient becomesmore and more restless, tossing uponthe bed or throwing himself from thebed to the floor, rolling about in the suffering reaches its height,vomiting may occur, which may in turn,be followed by sudden relief. Intervals. The cut edg-es of the cluodeiium are stitchedtogether, leaving a portion of the mucousmembrane exposed. A gall-stone pro-trudes partly through the duodenal open-ing of the common bile-duct. (Aiulerson.) of comparative ease may follow parox-ysms of pain, and this may continue forhours and even days. [Dr. H. B. Anderson, of Toronto, wit-nessed the case (unpublished) of awoman, aged 50, who died after sixmonths illness. Had deep jaundicethroughout; also pruritis, with, latterly, chills, fever, and purpura. Suffered nopain. Had previous attacks of cholelith-iasis with great pain, but no markedjaundice. Autopsy showed well-marked catarrhalcholangitis. Gall-bladder thickened, dis-torted, and atrophied, and contained asmall quantity of bile. Common ductgreatly dilated, had conical-shaped cal-culus impacted at and partly protrudingthrough the duodenal opening. (Seewood-cut.) On bacteriological examination, thecolon bacillus was found
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