The Waterbury Democrat., 1941-11-18
THE GALL OF SOME PEOPLE


 4 person who has chronic inflam- nation of the lining of the gall-sac, whether gall-stones are present or not, is likely to suffer periodic at- tacks of intestinal indigestion" as 1t is often called, with pain, flatu- lence or distension by gas, and of- ten distress or oppression referred to the heart, perhaps with some ir- regularity of heart action-all com monly attributed to "gas." During the attack the patient may belch a good deal and when considerable gas Is thus erupted relief may fol- low, so that the relief is attributed to getting rid Of the gas"-which is @ false inference. Mere presence of large amount of gas or air caus. es neither pain nor serious oppres- sion or embarrassment of the heart. The relief is actually due to suhsi- dence of idditation by excessive aci. dity, or to subsistence of the muscle spasm in stomach, gal-sac or bile- duct, the spasm of collie, and subsI- dence of such spasfn about the up- per part of the stomach permits gas to be freely belched, or about the lower end of the stomach per- mits the gas to pass along through the intestine.
 Such @ "gas attack" or acute inc testinal indigestion" severe enough to demand medical attention in the night, especially if 1t is a repeat performance and the patient is "fair-fat and forty" makes diag- nosis of cholecystitis (gal-bladder inflammation with or without gall- stones, at least fairly probable.
 Even though the patient com. plains of "acidity" or "sour stonl- ach" cfNcmical analysis shows low- CT acidity than normal in about two cases of gall-bladder trouble out of three.
 Dyspepsia is the chief complaint in two out of three cases. Pain is the chief complaint in one-third of the cases.
 The pain of inflammation of the gall-bladder is usually felt in the upper quadrant of the belly or in the lower part of the right chest, but sometimes 1t is referred to the back under the shoulder blade.
 One subject to cholecystitis should avoid all physics, as any and every pllysic is likely to cause contrac- tions of the gall-sac and produce or increase pain or collie.
 Naturally and normally the ejec- ton of the chyme (partly digested food mass) from the stomach into the duodenuIn, which occurs main ly two to three hours after a meal, stimulates contraction of the gail- sac and bile-ducs and expulsion or election of bile into the intestine where it is required for the further digestion of the chyme. This effect is more vigorous when the food happens to consist largely of fat, such as egg yolk, cream, butter, anil nal fats, olive oil. Hence 1t may be advisable to reduce the proportions of these foods in the diet when gall- bladder trouble is severe.
 It has been theoretically proposed t1AtAt tkAEoC A0OAD anu SSA tAAAA OeAANA Si notably peas, beans, wheat, liver and brains. because they contain considerable cholesterol, be exclud- ed from or kept at a minimum in the diet of the cholecystitis pa- tient, as cholesterol enters into the formation of most gall stones. I don't know much about 1t, but I doubt that this idea is of practical importance. do know that there is no sound reason why one with gal-bladder trouble should not eat all kinds of lean meats, cottage or Dutch cheese, milk, and all kinds of fruits and vegetables, with the possible exception of the two men, tioned-peas an dbeans. And I be- Meve one with ball-biadder trouble generally gets along more comfort- ably on four or five light or small meals than on two or three large or heavy meals daily.