Gall-stones and diseases of the bile-ducts . pdTTCJ\Vojv-H;Je Fig. 15.—Two groups of gall-stones formed around a threadaccidentally left in a gall-bladder (Homans). longer pathogenic when injected into the cellulartissue of animals. Homans recorded a case of interest in relation tothis experiment and also of importance in relationto the recrudescence of gall-stones. He performed cholecystotomy on a woman agedthirty-eight years, and removed ninety-seven gall-stones and closed the gall-bladder (cholecystendysis).On counting the gauze dabs one was missing, and GALL-STONES 53 could be felt in the
Gall-stones and diseases of the bile-ducts . pdTTCJ\Vojv-H;Je Fig. 15.—Two groups of gall-stones formed around a threadaccidentally left in a gall-bladder (Homans). longer pathogenic when injected into the cellulartissue of animals. Homans recorded a case of interest in relation tothis experiment and also of importance in relationto the recrudescence of gall-stones. He performed cholecystotomy on a woman agedthirty-eight years, and removed ninety-seven gall-stones and closed the gall-bladder (cholecystendysis).On counting the gauze dabs one was missing, and GALL-STONES 53 could be felt in the gall-bladder; this was reopened,the dab recovered, and the gall-bladder stitched tothe abdominal wound and drained. Twenty monthslater there was recurrence of symptoms which led toa second operation, and on opening the gall-bladder. Fig. 16.—Quadrilateral gall-stones, a, In section; b, Entire. the calculi represented in Fig. 15 were states that the thread on which they areformed was that used to close the gall-bladder atthe time the swab was sequestered, and it had notbeen removed. In regard to the recrudescence of gall-stones aftercholecystotomy the following observation, published 54 DISEASES OF THE BILE-DUCTS by Kehr, has, as Korte remarks, the value of anexperiment: Twelve cystotomised patients complained of pain,gastric trouble, and colic. The gall-bladder regionwas painful, the scar swollen, and there was evidenceof cholecystitis. In five he punctured with a fineneedle and withdrew turbid bile, which containedBacterium coli. This furnishes strong evidence forthose who advocate cholecystectomy. It might be urged that concretions are foundoccasionally in the bile-ducts of the newly-born whosebile is sterile; but these are soft bilirubin-calciumconcretions, and it is not out of question that t
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