The Bismarck tribune. [volume] (Bismarck, N.D.) 1916-current, 1932-10-07
WHAT GOOD IS A SQUEAKY
OLD GALLSAC?

Ben Told and Mrs. SumSey still
confuse the gall-bladder with the
bladder that serves as reservoir for
the kidney excretion. Probably the
confusion is due to the fact that
stones may form in either place.
The gall-bladder or gallsac is lit
tie pear-shaped sac lodged under the
right lobe of the liver, beneath the
edge of the ribs in the northwest
quadrant of the abdomen. 1t has
capacity of an ounce or a little more.
1t is blind sac, having only one
common inlet and outlet, like per-
fume atomer bulb or a camera bulb.
The tube through which bile enters
and leaves the gallsac is called the
cystic duct, 1-2 inches long, and as
one arm of Y it joins with the
other arm, the hepatic duct, coming
from the liver, to form the base, the
common bile duct, half the diameter
of a lead pencil, which conveys the
bile through its length, about three
inches, into the duodenum or upper
portion of the small intestine at a
point three inches below the lower
opening or outlet (pylorus) of the
stomach.
Bile or gall is secreted constantly
by the liver, but in the intervals be-
tween meals the supply of bile is
stored in the gall-bladder. Then
when some chyme (digesting food
is elected from the stomach through
the pylorus into the duodenum 1t
produces a reflex contraction of the
gall-bladder which elects squirt of
bile into the duodenum. Certain
kinds Of food produce more active
contractions of the gall-bladder and
therefore may be especially beneficial
where drainage Of the gall-bladder
Is desirable, or to be avoided where
the pain of collie or gall-sac inflam-
nation is present. We shall discuss
the diet question later.
Clearly the gall-bladder is a lux
ury one can do without. It's removal
causes no untoward effects. When it
is causing trouble it is as we'll re-
moved. Gall-sacs, tonsils and wis
dom teeth are all right to let alone
when they are normal; when they
cause trouble, out with them. Re-
moval Of the gall-sac does not in
terfere with the passage of the bile
or gall from the liver to the duode-
mum. Perhaps patients who have
had this operation need more fire.
quent meals for a while, to maintain
steady flow of bile.
Inflammation of the lining Of the
gall-bladder is called cholecystitis.
If concretions or gallstones form chat
is called cholelithiasis.
Acute cholecystitis is a severe ILL
ness somewhat like acute appended
tbs, and we need not consider it here.
Chronic cholecystitis is low grade
long continued gall-bladder trouble
This is more common than most VIC
Tins suppose, for large share of
cases Of chronic cholecystitis mas
querade for months or years as "dys-
pepsia." indigestion" "acidity,"
gas" stomach trouble" bilious
ness" and the like. One fact which
cannot be gainsaid: No distress from
acid, gas or indigestion" sufficiently
great to demand medical relief can be
ascribed to indulgence in any par
ticular food or to mere dietary in
discretion. When indigestion" is as
bad as that it is time to stop the
nonsense and find out what is the
matter with the patient. A so-called
''gas attack" in the wee small hours
warrants at least serious considera.
ton of the ACCESSIBILITY of a surgical
attack in the morning.