254 ILLINOIS STATE ACADEMY OF SCIENCE 



THREE HELPFUL AIDS IN THE DIAGNOSIS OF 

 GALL BLADDER DISEASE 



Frank Wright, Ph. C., M. D. 

 Department of Chemistry, Northwestern Uni- 

 versity Medical School 



Gall bladder disease so frequently disguises itself by a 

 long train of symptoms, stimulating disease of other organs, 

 that any additional means of obtaining definite informa- 

 tion is welcomed. Careful study of a rather large series 

 of cases prompts me to emphasize the aid one derives from 

 three sources. 



1. Trans-duodenal drainage of the gall bladder. 



2. Examination of the gall bladder region using re- 

 cently developed X-ray technique. 



3. Checking the pathological anatomy of such cases as 

 go to operation, with reference to the relation between 

 symptoms and the pathology in situ. 



Trans-duodenal aspiration or drainage of the gall blad- 

 der is readily applied as an adjunct to the fractional 

 method of examining the stomach contents. The usual 

 small tube, with perforated metal olive at the end, is al- 

 lowed to pass into the duodenum, after the fractions have 

 been aspirated from the stomach, the time of passage being 

 noted by the change in reaction, or the appearance of bile, 

 and checked as to the position by fluoroscopic examination. 

 After a couple of specimens have been obtained from the 

 duodenum, solution of magnesium sulphate is allowed to 

 flow by gravity, and aspirations follow at fifteen minute 

 intervals. 



Disregarding the question of duct contents, the appear- 

 ance of 30 to 50 mils of a bile differing in color, consis- 

 tency, and turbidity from the specimens which precede and 

 follow it, is taken as indication that this bile comes trom a 

 different source from that with which it is contrasted. 

 Repeated trials warrant the assumption that this bile 

 comes from the gall bladder. If in addition to these phy- 

 sical differences, microscopic and cultural examinations 



