Concrement Formation. 223 



varying grade; may cause dysuria (tenesmus) and pain of intense 

 severity (spasm of the involuntary musculature of the ureters, 

 bladder and urethra), local inflammation and erosion, obstruction 

 of urine, dilatation of the bladder and possibly rupture, hydrone- 

 phrosis, and submucous urinary infiltration and urinary intoxica- 

 tion of the blood. (For details cf. SpccicUc pat hoi Anatomic d. 



Hausfior, II. Bd.). 



Gall Stones (Cholelithiasis).— Although in man gall stones are 

 comparatively common (25 per cent, of women sufifer from them), 

 they are rather rare in animals. They are found as soft or half 

 solid, slippery bodies in the gall ducts and gall bladder, about the 

 size of a hazelnut but sometimes even larger than a fist, usually 

 multiple in numbers and often occurring in hundreds. Their color 

 is either a fine saiTron or ochre yellow, brick red or dark brown, 

 or they are whitish and chalky, with a yellowish or a greenish color 

 on the outside or in layers internally. The larger ones are rounded 

 or oval in form and in section they show a laminated structure ; or 

 thev are from mutual pressure faceted and polyhedral because of 

 their softness. 



Their composition varies. From analyses made by INIaly, Phip- 

 son, Hermann, of the gall stones of cattle, these concretions were 

 found peculiarly rich in bilirubin or the compound of bilirubin with 

 calcium (28-61 per cent.) and poor in cholesterin (only 1.35 per 

 cent. ; according to Zschokke, 10-15 per cent.) . E. Voit found in a gall 

 stone of a horse but little biliary pigment, no cholesterin, large 

 amounts of biliary acids, and in the ash chiefly calcium phosphate. 

 In the large examples not infrequently food particles (bits of cereals 

 or of hay or straw) are present, apparently forced from the intestine 

 into the widely dilated and relaxed biliary canal (peristalsis).* 



The origin of gall stones is not as yet entirely clear. Accord- 

 ing to Naunyn the mucous membrane of the gall passages in 

 catarrhal conditions produces a secretion rich in calcium salts, and 

 at the same time albumen is exuded into the bile. The presence 

 of the albumen favors the precipitation of the lime, and the increased 

 proportion of bilirubin may be explained by the thickening of 

 the bile from retardation of its flow. [The solid pigmentary sub- 

 stance in gall stones is a definite chemical combination between 

 calcium and bilirubin, the latter having feeble acid combining 

 powers.] 



♦Occasionally in swine and doer accnmulations of ordinary sand (silicate and 

 quartz fragments) have heen found, which could not possibly get into the biliar;r 

 passages except from duodenal contractions. 



