The rôle of gallbladder disease in the production of upper abdominal distress and of "dyspeptic" complaints is well recognized. Blackford and Dwyer1 in 1924, reporting a series of 1,650 cases presenting gastric symptoms, found that the organic pathologic condition of the abdomen causing the "dyspepsia" involved the gallbladder in 52 per cent of the cases. Crump2 in 1931, reporting a series of 1,000 routine postmortem examinations, found signs of chronic and healed cholecystitis in 300 cases. He concludes that upward of 40 per cent of the adult population have disorders of the biliary system.
Despite the widespread frequency of chronic cholecystitis, the principles of therapy are highly controversial. Judd, Crisp and Waldron3 state that, according to the present conception of chronic cholecystic disease, some change in the gallbladder wall represents the seat of the trouble and that removal of the organ is the only way to eradicate
BROWN CFG, DOLKART RE. KETO-CHOLANIC ACIDS IN THE MEDICAL MANAGEMENT OF LOW GRADE GALLBLADDER DISEASE. JAMA. 1937;108(6):458-461. doi:10.1001/jama.1937.02780060024006