Gall-stones and diseases of the bile-ducts . y vary insize from a cherry to a pigeons egg> (2) Laminated cholesterin stones.—These may con-tain nearly 90 per cent, of cholesterin, the remainingconstituents being* bilirubin-calcium in the brownand biliverdin-calcium in their green parts. Thesestones are hard but may be friable when dry. Theyare often distinctly facetted and on section displaylamina? which are coloured yellow, brown, and eveng*reen or red. In size and form they resemble purecholesterin calculi. The external layers are usuallyvitreous or earthy, but the structure is crystallin
Gall-stones and diseases of the bile-ducts . y vary insize from a cherry to a pigeons egg> (2) Laminated cholesterin stones.—These may con-tain nearly 90 per cent, of cholesterin, the remainingconstituents being* bilirubin-calcium in the brownand biliverdin-calcium in their green parts. Thesestones are hard but may be friable when dry. Theyare often distinctly facetted and on section displaylamina? which are coloured yellow, brown, and eveng*reen or red. In size and form they resemble purecholesterin calculi. The external layers are usuallyvitreous or earthy, but the structure is crystallinetowards the centre of the stone. GALL-STONES 45 (3) The common gall-bladder atones.—The bulk ofgall-stones are included in this category : theyvary in size, form, and tint, and are distinctlyfacetted. Their surfaces are usually yellow, but oftenbrown or white ; they are often no larger than thehead of a pin, and rarely exceed the dimensions ofa large cherry. When fresh they are often softand can be squeezed into a pulp. On section they. Fig. 9.—A group of common facetted gall-stones. are laminated, and within the nucleus there is fre-quently a cavity filled with yellow alkaline calculi do not exhibit any distinct crystallinestructure to the naked eye. (4) Mixed bilirubin-calcium calculi.—These stonesare usually as large as a cherry or larger. A solitarystone is common, but groups of three or four may befound in the gall-bladder or large bile-ducts. Whenmultiple they are facetted. These stones contain25 per cent, of cholesterin, the remainder being 46 DISEASES OF THE BILE-DUCTS bilirubin-calcium. The nucleus is cholesterin, coveredby thick layers of dark brown material which easilyflakes off. (5) Pure bilirubin-calcium calculi.—These stones
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