I shall restrict my remarks to the surgical aspect of biliary calculi, as a consideration of the causation, frequency, symptoms of the various phases, their diagnosis and discriminating diagnoses, widespread complications, prognosis and medical treatment, so-called, would lead me far beyond the limits of a thesis of this character.
It may not be amiss, however, in describing the surgery of the gall-tracts, to allude to the very great frequency of gall-stones, as almost all organic diseases of the biliary reservoir and ducts are directly or indirectly dependent upon them. The frequent findings of unsuspected gall-stones at autopsies is not a valid contraindication to operation in cases which, from certain complications, menace well-being and perhaps life.
The causation has been held to be the stagnation of bile with an altered condition of the epithelium, forming both the nucleus and media for their development and resulting from various mechanical, diathetic and inflammatory
HAGGARD WD. THE SURGERY OF BILIARY CALCULI.. JAMA. 1900;XXXV(1):10–14. doi:10.1001/jama.1900.24620270010001b