208 SYMPTOMATOLOGY. 



bladder are poured into the duodenum, simultaneously 

 with the entrance of the chyle from the stomach, where 

 the second process of digestion takes place. It is more 

 than probable that many a small stone has at this 

 moment been carried by the rush of bile through the 

 cystic duct into the common duct, and from thence into 

 the duodenum, without causing any marked pain or 

 inconvenience. With larger stones the case is different, 

 for as soon as a calculus is forced into the cystic duct, 

 pains are complained of at the margin of the liver and 

 epigastrium, accompanied by i. ing, and 



vomiting, With constipation and flatulence. These p 

 are very severe indeed excruciating and have been 



ribed to me as, first, aching, then bruising, then 

 boring, then burning, then sharp piercing, ulcera 1 

 and tearing, with a pitiable expression that something 

 were being torn to shreds in the stomach. In irri: 

 persons i ness, cramps, and convul- 



sions ; in the weakly, they becom< ml delirious. 



Tlir severity and duration of the colic varies according 

 to th' nardness and roii_ 



it may pass off' in a few hours, or it may continue for 

 many days. In the latter case it comes off and on in 

 ] 'ai' i with rigors, heats, and sweats; 



this continues till the duct is sufficiently dilated to 

 allow of the passage of the stone. i lus, after 



nng the te bladder; it 



may roll back like the small pebbles with the re<v 

 wave on the sea-shore nies it becomes lirmly 



imp;. :cally seals the neck of the bladder, 



which is often followed by s, 

 and even death. 



