512 Cholelithiasis. 



The sudden impaction of a lar,<>e .gallstone in the common 

 duct or in the neck of the gall bladder produces cramp-like 

 contractions of the wall of the duct. In this way horses and 

 occasionally cattle are attacked with colic-like pains (gallstone 

 colic). These pains may persist with remissions for some days 

 and then disappear. The colic is sometimes associated with 

 loss of consciousness (Birnbaum, Lewin). 



On the second or third day of the attack, and in some cases 

 earlier, there is biliary pigmentation of the mucous membranes 

 which appears suddenly with the onset of pain, and disappears 

 as quickly when the pain ceases. In cases in wiiich the neck of 

 the gall bladder is obstructed there may be no evidence of jaun- 

 dice. During the attacks of colic there is a rise of tempera- 

 ture. The pulse may be either rapid and small or slow and 

 full, and not rarely irregular. In addition to the constipation 

 and diarrhea vomiting is seen in the dog. Wyssmann ol)served 

 sjanptoms of hemorrhagic nephritis in a horse. 



The simultaneous occurrence of colic, jaundice, great de- 

 pression, and weak pulse affords the best indication as to the 

 nature of the condition, especially when the attacks of colic 

 are repeated at intervals. The sensitiveness to pressure and 

 the enlargement of the liver Avhicli can often be demonstrated 

 in these cases are of value for diagnosis. If the gallstone does 

 not move further, the jaundice gradually increases until the 

 patient finally dies showing symptoms of cholemia (see page 

 567.) Rupture of the gall bladder is followed by sudden col- 

 lapse, the animal dying in the course of one to two days from 

 acute peritonitis (Mollereau & Cagny). In a cow that had 

 died suddenly, Kohlhepp found intestinal contents in the great- 

 ly dilated gall bladder. 



Treatment. During the attacks of colic, narcotics, such as 

 morphia, injected subcutaneously, chloral hydrate per os or per 

 anum, and inhalation of chloroform are indicated. Mild pur- 

 gatives, such as olive oil, are likely to assist in moving the stone 

 by causing an immediate increase in the flow of l)ile. Para- 

 scandolo removed a gallstone from the bile duct of a dog by 

 laparotomy, recovery being established in four weeks. 



For the prevention of the formation of fresh stones, mod- 

 erate diet and plenty of exercise associated with an extended 

 course of neutral salts are indicated. 



Literature. Eherhard, B. t. W., 1905, 116.— Frohner, Monh., 1894, V, 61.— 

 Kohlhepp, B. Alt., 1905, 100.— Lewin, Z. f. Vk., 1905, 62.— Parascandolo, A. f. Tk., 

 1902, XXVTTT, 484.— Trolldenier, Monh., 1904, XV, 193 (Lit.).— Wyssmann, Schw. 

 A., 1906, XLVIII, 89 (Lit.). 



Foreign Bodies in the Liver and Bile Ducts. Occasionally pointed 

 foreign Indies perforate the reticulum or ahoniasura and penetrate into 

 the liver. This as a rule leads to the formation of an abscess in the 

 liver and the animal presents the symptoms of traumatic gastritis 

 and purulent hepatitis. Saint-Cyr found the straw of a leguminous 



