On gall-stones or cholelithiasis.

  • Edward Mansfield Brockbank
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: On gall-stones or cholelithiasis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    Lastly, the common bile-cUict not nufrequently opens separately from the pancreatic duct into the duodenum. Structure of the ducts.—The iutni-hepatic ducts have walls of fibrillar connective tissue, within which is a basement membrane and a lining of short columnar epithelium. According to Heideuhain, they also possess both longitudinally and circularly disposed muscular coats in their wall. In the portal canals, where they are somewhat larger, the ducts^ present numerous openings on the inner surface, which are scattered irregularly in the larger ducts, but in the subdivisions are arranged in two'longitudinal rows, one at each side of the vessel. These openings were formerly supposed to be the orifices of mucous glands; but, while the main ducts are studded with true mucous ghuuls of lobn- latcd form and with minute orifices, the openiugs now referred to belong to saccuhu- and tulnilar recesses, which are often branched and anastomosing, and may be beset all over with Ciecal projections. The larger bile-ducts and the gall-bladder have areolar coats, containing abundant elastic tissue and a certain amount of plain muscular tissue disposed both longitudinally and circularly. They are lintd with columnar epithelium. The lifmphatic vessels arise between the lobules, unite with larger vessels which run along the portal canals, and emerge at the port;il fissure. Other lymphatics accompany the branches of the hepatic veins, and others arise on the surface of the organ beneath the peri- toneum, which on the upper surface communicate with the thoracic lymphatics, and on the under surface with the lymphatics of Glisson's capsule. Varieties of Gall-stones. Tlie following classification and description of tlie different forms of calculi is that adopted by Naunyn.^ 1. Fnre Cholesterin Stones. — These are firm, yellowish-white, oval, or round calculi, varying in size from that of a cherry to that of a pigeon's egg or even larger. They rarely show any of the brown or greenish coloration which is an indication of the * • Klinik der Cholelithiasis,' 1892,
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