CHARACTER OF GALL-STONES. 199 



elated with fatty degeneration of the coats of the gall- 

 bladder, if not indeed immediately dependent upon 

 it. It may, therefore, be set down as a rule that the 

 presence of a gall-stone is direct evidence of an un- 

 natural condition of the bile; and the question now 

 arises, what condition of life, or what other influences, 

 tend to bring about those unhealthy conditions of the 

 bile on which the formation of gall-stones so clearly 

 depends ? There are some structural diseases of the 

 liver, where gall-stones are seldom or never found, namely, 

 the cirrhosis, or gin-drinker's liver, and those affected 

 with tropical abscess. The disease of the liver in 

 which gall-stones are most frequent is cancer and con- 

 sumption. Gall-stones are also frequently found in 

 conjunction with cancer of other organs of the body. 



CHARACTERS OF GALL-STONES. A solitary stone is but 

 seldom found in the gall-bladder ; in most cases they 

 occur in large numbers, varying from 5 or 10 to 1,000, 

 or more. I once found in the gall-bladder of a young 

 mail of twenty-two, who died of consumption, 31stones 

 of many forms, which, when put together formed a very 

 elegant little pyramid ; these were exhibited at a meet- 

 ing of the 15. H. S. some few years since. 



Mnrg;i^ni mentions a case where 3,000 stones were 

 found in the gall-bladder ; Hoffmann counted 3,646 in 

 another ; and Otto counted 7,802 stones which are pre- 

 served in his pathological museum in Berlin. Frerichs, 

 f'Mind in the gall-bladder of a woman aged sixty, who 

 died under his care at Breslau, 1,950 calculi. In size gall- 

 stones vary from a millet seed to a hen's egg, or even 

 larger ; in form they are primarily globular, but when 

 many congregate together they become altered in form. 



