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January 1927


Author Affiliations

Fellow in Surgery, the Mayo Foundation ROCHESTER, MINN.

Arch Surg. 1927;14(1):14-28. doi:10.1001/archsurg.1927.01130130018002

The conception of disease of the gallbladder is undergoing an interesting change. It now seems that often the early phenomena of disease of the gallbladder are concerned with metabolic changes, rather than bacterial. The study of the formation of gallstones may, therefore, enhance the study of metabolic diseases, as the two appear to be concerned with much the same phenomena.

TYPES OF GALLSTONES  If the classification of gallstones is based on their essential constituents, there are probably only two distinct types, the cholesterin stone and the bilirubin calcium stone. All other types of stones can be grouped with these two. A review of the essential features of each of the gross types of stones may simplify our classification and facilitate the study of the pathogenesis of biliary calculi.

Cholesterin Stone.  —Cholesterin stones have been classified in three groups by the pathologist: (1) the pure cholesterin stone, which contains free or

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