On the causation of cholelithiasis : an introduction to a discussion in the Section of Medicine at the Annual Meeting of the British Medical Association, Montreal, 1897 / by William Hunter.

  • Hunter, William, 1861-1937.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: On the causation of cholelithiasis : an introduction to a discussion in the Section of Medicine at the Annual Meeting of the British Medical Association, Montreal, 1897 / by William Hunter. 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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    Reprinted for the Author from the British Mkdical Journai., October 30th, 1897. An Introduction to a Discussion in the Section of Medicine at the Annual Meeting of the British Medical Association, Montreal, 1897. By william HUNTER, M.D., F.R.C.P., Curator and Pathologist, Charing Cross Hospital: Senior Assistant Physician, London FOver Hospital. The subject of cholelithiasis, which it is my privilege to bring before this Section, is one well fitted for discussion: A common disease affecting no fewer than 7 to 10 per cent, of cases, and yet in its mode of origin still exceedingly obscure; running a very varying clinical course, sometimes without symptoms, at other times the cause of the most intense suffering : presenting in its course problems in diagnosis and treatment baffling at times physician and surgeon alike. No portion of the subject presents greater difficulties tlian that of causation. And it is with this portion I am deputed by our President specially to deal. What are the conditions, general or local, that determine the formation of biliary concretions within the bile passages ? At the outset I would remark how slowly our knowledge of this subject has advanced; how limited it stiii is; how little, except in one or two particulars presently to be noted, it differs from that possessed 50 or even 150 years ago. Stagnation and inspissation of bile contributed to by advancing age, sedentary habits, inactive life, slowing of circulation, interference with movements of chest and abdo- men by such causes as lacing and pregnancy, consequent greater liability of women to suffer than men (five times greater)—all these were recognised and pointed out so long ago as 1757 by Thomas Coe.' In great part they represent the amount of the knowledge we have till recently possessed. Yet the Inadequacy of these various factors to account for the formation of gall stones was then, as now, fully recog- nised, the presence of gall stones in the young and active, their absence in the old and inactive. Did this represent all the knowledge we at present possess regarding the causation of cholelithiasis I confess I should have little satisfaction in discharging my present task.