On the morbid conditions of the bile and gall bladder / by Edwards Crisp.

  • Crisp, Edwards, 1806-1882.
Date:
1851
Catalogue details

Licence: Public Domain Mark

Credit: On the morbid conditions of the bile and gall bladder / by Edwards Crisp. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The ducts may be obliterated by acute or chronic inflammation, and transformed into fibrous cords. Andral. Clin. Med. obs. 48,49,50,51. Gazette des Hopitaux, 1843, p. 482, 568. St. Thomas’s Hospital Museum, ps. 48, 59. Spasm of the ducts is also described by many authors, but there can be no positive evidence of its existence, although the intense pain often occasioned by the passage of a gall-stone appears to be of a spasmodic character. Ossification. Ossification of the gall-bladder has been occasionally met with, but it is very rare. Preparation 1515, Chatham Museum. Baity'’s Morbid Anatomy. London Hunterian Museum, p. 1443. Dr. S. S. Allison, Medical Gazette, vol. 35, and King’s College Museum, p 259. Mr. Bagshaw, March, 1847, exhibited at the Bath Pathological Society an ossified gall-bladder, taken from a woman 70 years of age. The secretion of bile was not deficient, and there were no symptoms, except occasional bilious vomiting, that could be referred to this lesion. The ossific deposit was almost universal; a white pasty-looking matter, which contained 40 per cent, of cholesterine, was in the cavity. Pro- vincial Journal, 1847. Malignant disease is seldom confined to this part. When in Dublin, in 1848, I saw an interesting case at the Meath Hospital, under the care of my friend Dr. Lees. A man, 62 years of age, gradually sunk from diseased liver ; this organ was hard, almost globular in form, and studded with hard tubercles of various sizes, but the gall-bladder presented a curious appearance, being entirely covered with these excrescences ; the common duct was diminished in caliber by one of them, but it was not impervious. The inner surface of the gall-bladder was irregular. A few tubercles were present also in the omentum and right pleura. Dr. Burridge, in a woman set 42, who had a small hard tumor in the mamma, and a single carcinomatous tubercle in the liver; found a scirrhous mass in the place of the gall-bladder, a part of the common duct only being visible. Provincial Journal, 1845. See also ps. 3, 4, 6, 13, St. Bartholomew’s Museum; and ps. 242, 244, King’s College Museum; and Cruveilhier, Anat. Path. Liv. 12. In addition to the above lesions, there may be hypertrophy of the muscular coat of the gall-bladder. I saw a good example of this in a man at St. Thomas’s Hospital, 1838, who had jaundice from enlarge pancreas. The gall-bladder was dilated, and the muscular coa‘ thickened, in consequence, I suppose, of its increased efforts to expe' the bile. In this case the teeth and arteries were of a bright yellow] colour. Anomalies of form may exist—membranous septa and bands (plate fig. 3.) divide its cavity, and pouches, project from its parietes. Lon-j don Hunterian Museum, p. 1448. Guy’s Museum, p. 1956. Melanosis] may affect the gall-bladder (King’s College Museum, p. 242); pus ma be in its cavity, and sometimes calculi are found adherent to itf| parietes. Guy’s Museum, p. 1963. London Hunterian Museum, ps 1444, 1446. St. Bartholomew’s Museum, p. 5. Hydatids have beer present in the cavity of this viscus, increasing its size to an enormou extent: extraneous bodies, such as pins, needles, globules of mercury, and lumbrici have found their way into the gall-bladder, and the first mentioned have formed the nuclei of gall-stones. Boston Journal, 1844|