An early diagnosis of cholelithiasis is important for the welfare of the patient. When we consider the complications and sequelæ that may arise after prolonged irritation from the presence of gall-stones in the bladder or ducts, this becomes more apparent.
These complications may be septicemia, ulceration of the gall-bladder and ducts, permitting the calculi to escape into the adjoining viscera, derangement of the liver from obstruction or abscess, cancer from irritation, obstruction of the pylorus, various nervous phenomena, and general debility. Unfortunately there are no pathognomonic symptoms in the early stages that serve to make a positive diagnosis.
From a careful study of 20 cases coming under my notice in the last few years, of which full clinical records are made, I have been able to make some deductions that may prove interesting and valuable to the profession.
My records show quite a number of other cases in which the
MEANS WJ. THE DIAGNOSIS AND TREATMENT OF CHOLELITHIASIS.. JAMA. 1900;XXXV(22):1393–1396. doi:10.1001/jama.1900.24620480013001a