A review of the literature on infections of the biliary tract reveals the fact that there is a wide difference of opinion as regards both the frequency and the nature of an hepatic involvement in association with the relatively simple and more common types of cholecystitis. Such conditions as liver abscess and "obstructive biliary cirrhosis" in association with infections of the biliary tract have long been known. But the changes in the liver which occur in connection with the relatively simple types of cholecystitis which are so commonly encountered at operation seem not to have been investigated until the study made by one of us (Graham), the results of which were published in 1918.1 In general, the only evidence of hepatic involvement which has been considered has been an increase in the size of the liver. Kehr2 quotes Langenbach as saying that an enlargement of the liver is