Atlanta tri-weekly journal. [volume] (Atlanta, Ga.) 1920-19??, 1921-07-14
GLADSTONE DISEASE
By H. Addington Bruce

ALL-STONES are popularity supposed to
I r be always productive OF serious trouble,
- usually neceSSitating surgical action. This
is so far from being the case that, according to
one eminent gall-biadder surgeon, only about
per cent of those afflicted with gall-stoneS
have to seek surgical aid.
Other experienced physicians further main
tain that gall-StoneS cause pain and other deli
mite symptoms in barely more than 5 per cent
of all cases. Yet Sonumerous are gladstone
carriers" that some pathologists have reported
finding gall-StoneS In almost 10 per cent OF
the autopSeS made by them.
AS to the cause ofgall-StoneS there still IS
much uncertainty, though there seems to be
no doubt that infection commonly plays lead
ing part. Again and again gladstone disease
has developed following attacks of streptococ-
Gus throat infection, pneumonia, influenza, and
typhoid fever. Concerning the relation be-
tween typhoid and gal-tones Richard Cabot
remarks, in his "Medicine for the Layman:"
"The typhoid bacillus gets into the gall-blad-
der and presumably causes a low grade inflanl-
nation there. Then nature gets busy trying to
squelch that inflammation and builds wall
around the bacilli. There results stone which
often gives trouble.
"When we cut open these stones We may
find a live typhoid bacillus, even thirty-f
years after an attack, as in one caSe-Shut up
there harmless, but at a great price to the
body"
lection may act to produce gall-Stones. This
is suggested by, for instance, the fact noted
by EiSman that gall-StoneS occur twice as
often in women as in men. And they occur
more frequently in stout women than in any
other type of person.
Hence, as a preventive measure against gall
stone disease, effort to avoid obesity would
seem to be particularly indicated, in addition
to general living habits calculated to keep up
the resistance to germ infections, though avoid
ance of obesity can hardly be said to confer
absolute immunity.
Regarding symptoms, the most typical is a
collie, described by Cabot as "'the severest
pain that most individuals who have it have
ever had" This is caused usually by passage of
the stone from the gal-bladder. The attack
subsidies either when the stone is spontaneous
ly expelled from the body or slips back into
the gall-bladder.
But, depending chiefly on their size and To-
cation, gall-StoneS may give rise to most va
ried symptoms, with or without recurrent at
tacks of collie. 1t is this great variety that
often makes the diagnosis of gladstone disease
extremely difficult. Though fortunately, dag
noSiS has been much facilitated in recent years
by the possibility of making X-ray examina-
tons.
Repeated attacks of collie or indications of
serious intestinal obstruction call Enthusiastically
for. surgical treatment. Otherwise medicinal
and hygienic ENTHUSIASTICALLY in the way
OF administering a pain destroyer when neces-
Sary, keeping the patient in bed and pre-
Scribing saline aperientS and the drinking of
large amounts of waterway suffice to elm
mate the offending stone.
(Copyright,t92 by The Associated Neewspa-
perS)