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March 14, 1908

THE GENESIS OF GALLSTONES.

JAMA. 1908;L(11):880. doi:10.1001/jama.1908.02530370046006

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Abstract

Certain recent work on this subject seems to be of sufficient importance to deserve critical comment. Nearly fifty years ago Thudicum originated the theory that gallstones were formed by the precipitation of cholesterin and certain calcium compounds as a result of the bile becoming acid. This acidity he believed was due to decomposition of the bile on long standing or to a hypersecretion of mucus. Since this was long before the discovery of bacteria, decomposition was considered purely a chemical change and hence the theory was known for years as the chemical theory.

Naunyn especially has given us much information on the subject of the formation of gallstones, and to-day his classification and explanation of their origin have come to be generally accepted. According to him inflammation plays a most important rôle and is usually the beginning of the process. This is nearly always due to an infection with either

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