Gall-stones and diseases of the bile-ducts . g hydrops may appro-priately be applied to such a condition. In another class of case the gall-bladder may befirmly contracted on a solitary gall-stone, the surfaceof which is rough and tuberculated (Fig. 24), thesmall tubercles representing casts of the pits in themucous membrane of the gall-bladder. Occasionally when the gall-bladder contains nume-rous calculi of different sizes, its walls may contracton them firmly and press them together, so that onopening the gall-bladder it will require some forceto extract the stones. If such a gall-bladder b
Gall-stones and diseases of the bile-ducts . g hydrops may appro-priately be applied to such a condition. In another class of case the gall-bladder may befirmly contracted on a solitary gall-stone, the surfaceof which is rough and tuberculated (Fig. 24), thesmall tubercles representing casts of the pits in themucous membrane of the gall-bladder. Occasionally when the gall-bladder contains nume-rous calculi of different sizes, its walls may contracton them firmly and press them together, so that onopening the gall-bladder it will require some forceto extract the stones. If such a gall-bladder beremoved entire and its wall be partly peeled off thestones form a rude mosaic (Fig. 25), or if the calculiare of the same size, the appearance is not unlike thatof a head of ripe maize (Fig. 20), the thick mucus acting CONSEQUENCES OF GALL-STONES 65 as cement. In rarer instances an enlarged gall-bladder contains a crowd of loose stones, and whenit hangs low in the abdomen and the belly wall isthin the calcnli may be made to rub together. I. fiVTT£/?WofcjfiA Fig. 24.—A solitary gall-stone in a contracted gall-bladder(Museum of the Royal College of Surgeons). have seen an example of this in a thin, emaciated oldwoman. When a gall-bladder contains two large calculiand contracts upon them it will assume an hour-glassshape, and if it be bisected the two distended por-tions will be found separated by a perforated 6Q DISEASES OF THE BILE-DUCTS diaphragm. Bilocular gall-bladders are common,and occasionally, when containing several stones offair size each, may be lodged in a recess and pro-
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