The American Journal of the Medical Sciences, 1857, Vol. 33 (Classic Reprint)

The diagnosis Of diseases Of the gall-bladder is, under all circumstances, attended with considerable difficulty; and, in fact, in most instances nothing but an approximation to the real state of the case can be attained. The chief reason of this, no doubt, may be found in the comparatively unimportant part which this viscus plays in the animal economy - its especial function being merely to retain the bile secreted by the liver until intestinal digestion commences. The cystic bile, it is true, owing to the absorption of its watery particles, is rendered more acrid and viscid, and therefore, perhaps, in this concentrated form, is better qualified to promote primary assimilation, calori fication, or whatever function may be assigned to it. Nevertheless it is cer tain that, in numerous instances, there have been congenital deficiencies of the gall-bladder, or atrophy Of the same-as the result of a permanent closure of its duct, from adhesive in?ammation, gall-stone, or other cause - without giving rise to any appreciable disturbance of the system. Under the last named circumstances, it has been asserted that the continuous ?ow of bile into the duodenum tended to stimulate the digestive organs, and thus excite an incessant craving for food, or morbid appetite, such as sometimes attends certain forms of dyspepsia. More accurate Observation, however, has refuted these views - so that we cannot even rely upon this symptom as an aid in the diagnosis of the diseases under consideration.

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