A Treatise On Clinical Medicine

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Cholesterin is found in abundance wherever degeneration of cells is going on. It is, therefore, present in every catarrhal discharge of a mucous membrane, as in the sputum of bronchitis and of phthisis, or wherever there is pus. So soon as the catarrhal condition of the gall- bladder sets in the cholesterin may be seen in discrete drops in the degenerated epithelial cells of the mucous membrane, which set it free to adhere to other similar drops, leading to the important deduc- tion that the co...mponents of gall-stones are not derived from the liver itself, but are generated by a local derangement of the mucous mem- brane of the biliary passages and of the gall-bladder.
Our progress in the pathology of cholelithiasis, however, shows that gall-stones are direct results of infection. Everything else must be contributory, but it is the entrance into the biliary passages of micro- organisms which is the efficient cause, as it is due to them that catarrh of the mucous membranes is set up. Much the most common of these bacterial invaders, as we might expect, is the Bacillus coli communis.


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