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August 4, 1906


Author Affiliations

Professor of Medicine at the New York Post-Graduate Medical School and Hospital; Physician to St. Mark's Hospital. NEW YORK.

JAMA. 1906;XLVII(5):347-350. doi:10.1001/jama.1906.25210050031002g

If one should formulate his conclusions from the reading of current medical literature, he would likely be of the opinion that my paper would be, of necessity, an extremely brief one. However, voluminous as is the surgical literature on gallstones, a careful consideration of the subject leads me to place surgery as adapted only to gallstones of gall-bladder origin, and then only under conditions which demand mechanical relief—obviously a very small part of the subject of gallstone disease which is almost entirely medical. When we consider that postmostem records prove that from 6 to 10 per cent. of all cadavers show the presence of gallstones— three-quarters of these being in persons over 40 years old—and that not more than one person in twenty who carries a gallstone becomes aware of its presence through any symptoms which it may cause, and of those whose symptoms have attracted attention, not all require

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