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THE GALLBLADDER: ITS FUNCTIONS AND SOME OF THEIR DISTURBANCES IN THE LIGHT OF RECENT INVESTIGATIONS

THE GALLBLADDER: ITS FUNCTIONS AND SOME OF THEIR DISTURBANCES IN THE LIGHT OF RECENT INVESTIGATIONS Abstract The purpose and functions of the biliary vesicle are still debated problems (Mann,1 Haberland,2 Rost,3 Lütkens,4 Chiray and Pavel,5 Pfuhl,6 Westphal and Schöndube,7 Boyden,8 Blond,9 Babkin,10 Körte,11 Moynihan,12 Lyon,13 Whitaker,14 Rolleston and McNee15). The view most widely accepted regards the gallbladder as a reservoir the function of which is to supply concentrated bile whenever there is call for such in the intestine. This traditional concept, however, as may easily be gathered from the literature, does not provide the best explanation for such phenomena as the formation of biliary concretions and hydrops of the gallbladder, nor does it account for the occasional absence of clinical signs or symptoms in the presence of gallstones, and the not infrequent occurrence of typical signs and symptoms of cholelithiasis in the absence of concretions. The appreciation of this fact, i. References 1. Mann, F. C.: The Functions of the Gallbladder , Physiol. Rev. 4:251, 1924. 2. Haberland, H. F. O.: Studien an den Gallenwegen , Arch. f. klin. Chir. 130:625, 1924. 3. Rost, Franz: Pathologische Physiologie des Chirurgen , Leipzig, F. C. W. Vogel, 1925. 4. Lütkens, Ulrich: Aufbau und Funktion der extrahepatischen Gallenwege , Leipzig, F. C. W. Vogel, 1926. 5. Chiray, M., and Pavel, I.: La vésicule biliaire , Paris, Masson et Cie, 1927. 6. Pfuhl, Wilhelm: Beitrag zur physiologischen Anatomie der Gallenblase , Arch. f. klin. Chir. 147:490, 1927. 7. Westphal, K., and Schöndube, W.: Einige Bemerkungen zur Physiologie der extrahepatischen Gallenwege , Klin. Wchnschr. 6:2417, 1927.Crossref 8. Boyden, Edward A.: Concerning the Prevalent Denial of Functions Long Attributed to the Gall Bladder , Surg. Gynec. Obst. 46:30, 1928. 9. Blond, Kasper: Eine neue Arbeitshypothese zur Klärung der Gallenwegsprobleme , Arch. f. klin. Chir. 149:662, 1928. 10. Babkin, B. P.: Die äussere Sekretion der Verdauungsdrüsen , Berlin, Julius Springer, 1928. 11. Körte, Werner: Die Erkrankungen der Gallenwege , Dresden and Leipzig, Theodor Steinkopff, 1928. 12. Moynihan, Berkeley: Addresses on Surgical Subjects , Philadelphia and London, W. B. Saunders Company, 1928. 13. Lyon, B. B. Vincent: Can the Gallbladder Empty Through Duodenal Biliary Drainage? Is the Gallbladder the Source of "B" Bile? Arch. Int. Med. 43:147 ( (Feb.) ) 1929.Crossref 14. Whitaker, Lester R.: Problems in Normal and in Abnormal Physiology of the Gallbladder , Arch. Surg. 18:1783 ( (April) ) 1929.Crossref 15. Rolleston, Humphry; and McNee, John William: Diseases of the Gall-Bladder and Bile-Ducts , London, Macmillan and Co., 1929. 16. Berg, John: Studien über die Funktion der Gallenwege unter normalen und gewissen abnormen Verhältnissen , Acta chir. Skandinav. Supp. 2:1, 1922. 17. Berg, John: Einleitungsvortrag zum Thema "Gallensteinleiden," Arch. f. klin. Chir. 126:329, 1923. 18. Aschoff, L.: Ueber Orthologie und Pathologie der extrahepatischen Gallenwege , Arch. f. klin. Chir. 126:233, 1923. 19. Aschoff, Ludwig: Lectures on Pathology , New York, Paul B. Hoeber, Inc., 1924. 20. Rous, Peyton; and McMaster, Philip D.: The Concentrating Activity of the Gall Bladder , J. Exper. Med. 34:47, 1921.Crossref 21. Aschoff, L., and Bacmeister, A.: Die Cholelithiasis , Jena, Gustav Fischer, 1909. 22. Halpert, Béla: Neue Wege in der Gallenblasenforschung: I and II , Med. Klin. 20:408 and 1830, 1924. 23. Sweet, J. E.: The Gall-Bladder; Its Past, Present and Future , Internat. Clin. 1:187, 1924. 24. Virchow, R.: Ueber das Epithel der Gallenblase und über einen intermediären Stoffwechsel des Fettes , Virchows Arch. f. path. Anat. 11:574, 1857.Crossref 25. Graham, Evarts A., and Cole, Warren H.: Roentgenologic Examination of the Gallbladder , J. A. M. A. 82:613 ( (Feb. 23) ) 1924.Crossref 26. Graham, Evarts A.; Cole, Warren H.; Copher, Glover H., and Moore, Sherwood: Diseases of the Gall Bladder and Bile Ducts , Philadelphia, Lea and Febiger, 1928. 27. Boyden, Edward A.: A Study of the Behavior of the Human Gall Bladder in Response to the Ingestion of Food; Together with Some Observations on the Mechanism of the Expulsion of Bile in Experimental Animals , Anat. Rec. 33:201, 1926.Crossref 28. Blond, Kasper: Footnote 9. Zum Entlehrungsmechanismus der extrahepatischen Gallenwege , Deutsche med. Wchnschr. 54:778, 1928.Crossref 29. Boyden, Edward A.: An Analysis of the Reaction of the Human Gall Bladder to Food , Anat. Rec. 40:147, 1928.Crossref 30. Whitaker, Lester R.: The Mechanism of the Gall Bladder , Am. J. Physiol. 78:411, 1926. 31. Higgins, G. M., and Mann, F. C.: Observations on the Emptying of the Gall Bladder , Am. J. Physiol. 78:339, 1926. 32. Hamrick, Robert A.: The Emptying of the Gall Bladder: An Experimental Study , Am. J. M. Sc. 174:168, 1927.Crossref 33. Ivy, A. C., and Oldberg, Eric: A Hormone Mechanism for Gall Bladder Contraction and Evacuation , Am. J. Physiol. 84:599, 1928. 34. Heister, Laurentius: Compendium Anatomicum, Amsterdam, 1723. 35. Löhner, L.: Gallen- und Gallenwegstudien I. Zur Füllungs- und Entleerungsmechanik der Gallenblase und über die Funktion der Valvulae Heisteri , Arch. f. d. ges. Physiol. 211:356, 1926.Crossref 36. Mentzer, Stanley H.: The Valves of Heister , Arch. Surg. 13:511 ( (Oct.) ) 1926.Crossref 37. Sweet, J. E.: The Importance to Surgery of the Cystic Duct , Am. J. Surg., new series , 3:274, 1927.Crossref 38. Burget, G. E.: The Regulation of the Flow of Bile , Am. J. Physiol. 81:422, 1927. 39. Halpert, Béla: Morphological Studies on the Gall-Bladder: I. A Note on the Development and the Microscopic Structure of the Normal Human Gall-Bladder , Bull. Johns Hopkins Hosp. 40:390, 1927. 40. Wislocki, George B.: Observations on the Gross and Microscopic Anatomy of the Sloths , J. Morphol. & Physiol. 46:317, 1928. 41. Boyden, Edward A.: The Accessory Gall-Bladder; an Embryological and Comparative Study of Aberrant Biliary Vesicles Occurring in Man and the Domestic Mammals , Am. J. Anat. 38:177, 1926. 42. Halpert, Béla; and Lewis, Julian H.: Experimental Studies on the Isolated Gall Bladder of the Dog , Anat. Rec. 42:50, 1929. 43. Halpert, Béla: A Note on the "True Luschka Ducts" and the "Rokitansky-Aschoff Sinuses" of the Human Gall-Bladder , Anat. Rec. 32:232, 1926. 44. Halpert, Béla: Morphological Studies on the Gall-Bladder: II. The "True Luschka Ducts" and the "Rokitansky-Aschoff Sinuses" of the Human Gall-Bladder , Bull. Johns Hopkins Hosp. 41:77, 1927. 45. Halpert, Béla; and Hanke, Milton T.: Observations on the Function of the Gall Bladder , Am. J. Physiol. 88:351, 1929. 46. Mann, Frank C.: A Physiologic Consideration of the Gallbladder , J. A. M. A. 83:829 ( (Sept. 13) ) 1924. 47. Halpert, Béla; and Hanke, Milton T.: Some Observations on the Excretion of Certain Chemicals by the Biliary System of the Rabbit , Anat. Rec. 42:49, 1929. 48. Halpert, Béla; and Hanke, Milton T.: The Excretion of Methylene Blue (Methylthionine Chloride, U.S.P.) by the Biliary System of the Rabbit; Its Significance for the Conception of Hepatogenous Stasis in the Gallbladder , Arch. Path. 7:473, 1929. 49. Boyd, William: Studies in Gall-Bladder Pathology , Brit. J. Surg. 10:337, 1923. 50. Mentzer, S. H.: Cholesterosis of the Gallbladder , Am. J. Path. 1:383, 1925. 51. Halpert, Béla: New Aspects of the Formation and Classification of Gallstones , Arch. Path. 6:623 ( (Oct.) ) 1928. 52. Schade, H.: Die physikalische Chemie in der inneren Medizin , Dresden and Leipzig, Theodor Steinkopff, 1923. 53. Lichtwitz, L.: Ueber die Bildung der Harn- und Gallensteine , Ergebn. d. inn. Med. u. Kinderh. 13:1, 1914. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

THE GALLBLADDER: ITS FUNCTIONS AND SOME OF THEIR DISTURBANCES IN THE LIGHT OF RECENT INVESTIGATIONS

Archives of Surgery , Volume 19 (6) – Dec 1, 1929

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American Medical Association
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Copyright © 1929 American Medical Association. All Rights Reserved.
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0004-0010
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Abstract

Abstract The purpose and functions of the biliary vesicle are still debated problems (Mann,1 Haberland,2 Rost,3 Lütkens,4 Chiray and Pavel,5 Pfuhl,6 Westphal and Schöndube,7 Boyden,8 Blond,9 Babkin,10 Körte,11 Moynihan,12 Lyon,13 Whitaker,14 Rolleston and McNee15). The view most widely accepted regards the gallbladder as a reservoir the function of which is to supply concentrated bile whenever there is call for such in the intestine. This traditional concept, however, as may easily be gathered from the literature, does not provide the best explanation for such phenomena as the formation of biliary concretions and hydrops of the gallbladder, nor does it account for the occasional absence of clinical signs or symptoms in the presence of gallstones, and the not infrequent occurrence of typical signs and symptoms of cholelithiasis in the absence of concretions. The appreciation of this fact, i. References 1. Mann, F. C.: The Functions of the Gallbladder , Physiol. Rev. 4:251, 1924. 2. Haberland, H. F. O.: Studien an den Gallenwegen , Arch. f. klin. Chir. 130:625, 1924. 3. Rost, Franz: Pathologische Physiologie des Chirurgen , Leipzig, F. C. W. Vogel, 1925. 4. Lütkens, Ulrich: Aufbau und Funktion der extrahepatischen Gallenwege , Leipzig, F. C. W. Vogel, 1926. 5. Chiray, M., and Pavel, I.: La vésicule biliaire , Paris, Masson et Cie, 1927. 6. Pfuhl, Wilhelm: Beitrag zur physiologischen Anatomie der Gallenblase , Arch. f. klin. Chir. 147:490, 1927. 7. Westphal, K., and Schöndube, W.: Einige Bemerkungen zur Physiologie der extrahepatischen Gallenwege , Klin. Wchnschr. 6:2417, 1927.Crossref 8. Boyden, Edward A.: Concerning the Prevalent Denial of Functions Long Attributed to the Gall Bladder , Surg. Gynec. Obst. 46:30, 1928. 9. Blond, Kasper: Eine neue Arbeitshypothese zur Klärung der Gallenwegsprobleme , Arch. f. klin. Chir. 149:662, 1928. 10. Babkin, B. P.: Die äussere Sekretion der Verdauungsdrüsen , Berlin, Julius Springer, 1928. 11. Körte, Werner: Die Erkrankungen der Gallenwege , Dresden and Leipzig, Theodor Steinkopff, 1928. 12. Moynihan, Berkeley: Addresses on Surgical Subjects , Philadelphia and London, W. B. Saunders Company, 1928. 13. Lyon, B. B. Vincent: Can the Gallbladder Empty Through Duodenal Biliary Drainage? Is the Gallbladder the Source of "B" Bile? Arch. Int. Med. 43:147 ( (Feb.) ) 1929.Crossref 14. Whitaker, Lester R.: Problems in Normal and in Abnormal Physiology of the Gallbladder , Arch. Surg. 18:1783 ( (April) ) 1929.Crossref 15. Rolleston, Humphry; and McNee, John William: Diseases of the Gall-Bladder and Bile-Ducts , London, Macmillan and Co., 1929. 16. Berg, John: Studien über die Funktion der Gallenwege unter normalen und gewissen abnormen Verhältnissen , Acta chir. Skandinav. Supp. 2:1, 1922. 17. Berg, John: Einleitungsvortrag zum Thema "Gallensteinleiden," Arch. f. klin. Chir. 126:329, 1923. 18. Aschoff, L.: Ueber Orthologie und Pathologie der extrahepatischen Gallenwege , Arch. f. klin. Chir. 126:233, 1923. 19. Aschoff, Ludwig: Lectures on Pathology , New York, Paul B. Hoeber, Inc., 1924. 20. Rous, Peyton; and McMaster, Philip D.: The Concentrating Activity of the Gall Bladder , J. Exper. Med. 34:47, 1921.Crossref 21. Aschoff, L., and Bacmeister, A.: Die Cholelithiasis , Jena, Gustav Fischer, 1909. 22. Halpert, Béla: Neue Wege in der Gallenblasenforschung: I and II , Med. Klin. 20:408 and 1830, 1924. 23. Sweet, J. E.: The Gall-Bladder; Its Past, Present and Future , Internat. Clin. 1:187, 1924. 24. Virchow, R.: Ueber das Epithel der Gallenblase und über einen intermediären Stoffwechsel des Fettes , Virchows Arch. f. path. Anat. 11:574, 1857.Crossref 25. Graham, Evarts A., and Cole, Warren H.: Roentgenologic Examination of the Gallbladder , J. A. M. A. 82:613 ( (Feb. 23) ) 1924.Crossref 26. Graham, Evarts A.; Cole, Warren H.; Copher, Glover H., and Moore, Sherwood: Diseases of the Gall Bladder and Bile Ducts , Philadelphia, Lea and Febiger, 1928. 27. Boyden, Edward A.: A Study of the Behavior of the Human Gall Bladder in Response to the Ingestion of Food; Together with Some Observations on the Mechanism of the Expulsion of Bile in Experimental Animals , Anat. Rec. 33:201, 1926.Crossref 28. Blond, Kasper: Footnote 9. Zum Entlehrungsmechanismus der extrahepatischen Gallenwege , Deutsche med. Wchnschr. 54:778, 1928.Crossref 29. Boyden, Edward A.: An Analysis of the Reaction of the Human Gall Bladder to Food , Anat. Rec. 40:147, 1928.Crossref 30. Whitaker, Lester R.: The Mechanism of the Gall Bladder , Am. J. Physiol. 78:411, 1926. 31. Higgins, G. M., and Mann, F. C.: Observations on the Emptying of the Gall Bladder , Am. J. Physiol. 78:339, 1926. 32. Hamrick, Robert A.: The Emptying of the Gall Bladder: An Experimental Study , Am. J. M. Sc. 174:168, 1927.Crossref 33. Ivy, A. C., and Oldberg, Eric: A Hormone Mechanism for Gall Bladder Contraction and Evacuation , Am. J. Physiol. 84:599, 1928. 34. Heister, Laurentius: Compendium Anatomicum, Amsterdam, 1723. 35. Löhner, L.: Gallen- und Gallenwegstudien I. Zur Füllungs- und Entleerungsmechanik der Gallenblase und über die Funktion der Valvulae Heisteri , Arch. f. d. ges. Physiol. 211:356, 1926.Crossref 36. Mentzer, Stanley H.: The Valves of Heister , Arch. Surg. 13:511 ( (Oct.) ) 1926.Crossref 37. Sweet, J. E.: The Importance to Surgery of the Cystic Duct , Am. J. Surg., new series , 3:274, 1927.Crossref 38. Burget, G. E.: The Regulation of the Flow of Bile , Am. J. Physiol. 81:422, 1927. 39. Halpert, Béla: Morphological Studies on the Gall-Bladder: I. A Note on the Development and the Microscopic Structure of the Normal Human Gall-Bladder , Bull. Johns Hopkins Hosp. 40:390, 1927. 40. Wislocki, George B.: Observations on the Gross and Microscopic Anatomy of the Sloths , J. Morphol. & Physiol. 46:317, 1928. 41. Boyden, Edward A.: The Accessory Gall-Bladder; an Embryological and Comparative Study of Aberrant Biliary Vesicles Occurring in Man and the Domestic Mammals , Am. J. Anat. 38:177, 1926. 42. Halpert, Béla; and Lewis, Julian H.: Experimental Studies on the Isolated Gall Bladder of the Dog , Anat. Rec. 42:50, 1929. 43. Halpert, Béla: A Note on the "True Luschka Ducts" and the "Rokitansky-Aschoff Sinuses" of the Human Gall-Bladder , Anat. Rec. 32:232, 1926. 44. Halpert, Béla: Morphological Studies on the Gall-Bladder: II. The "True Luschka Ducts" and the "Rokitansky-Aschoff Sinuses" of the Human Gall-Bladder , Bull. Johns Hopkins Hosp. 41:77, 1927. 45. Halpert, Béla; and Hanke, Milton T.: Observations on the Function of the Gall Bladder , Am. J. Physiol. 88:351, 1929. 46. Mann, Frank C.: A Physiologic Consideration of the Gallbladder , J. A. M. A. 83:829 ( (Sept. 13) ) 1924. 47. Halpert, Béla; and Hanke, Milton T.: Some Observations on the Excretion of Certain Chemicals by the Biliary System of the Rabbit , Anat. Rec. 42:49, 1929. 48. Halpert, Béla; and Hanke, Milton T.: The Excretion of Methylene Blue (Methylthionine Chloride, U.S.P.) by the Biliary System of the Rabbit; Its Significance for the Conception of Hepatogenous Stasis in the Gallbladder , Arch. Path. 7:473, 1929. 49. Boyd, William: Studies in Gall-Bladder Pathology , Brit. J. Surg. 10:337, 1923. 50. Mentzer, S. H.: Cholesterosis of the Gallbladder , Am. J. Path. 1:383, 1925. 51. Halpert, Béla: New Aspects of the Formation and Classification of Gallstones , Arch. Path. 6:623 ( (Oct.) ) 1928. 52. Schade, H.: Die physikalische Chemie in der inneren Medizin , Dresden and Leipzig, Theodor Steinkopff, 1923. 53. Lichtwitz, L.: Ueber die Bildung der Harn- und Gallensteine , Ergebn. d. inn. Med. u. Kinderh. 13:1, 1914.

Journal

Archives of SurgeryAmerican Medical Association

Published: Dec 1, 1929

References