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Gall-Stones in the Insane

Published online by Cambridge University Press:  19 February 2018

Cecil F. Beadles*
Affiliation:
Colney Hatch Asylum

Extract

Gall-stones are stated to be most common in females of advanced years by all writers on the subject, but is the frequency of their occurrence in such cases fully recognized? There is a further question, one which more immediately affects the medical officers at asylums, and which it is possible to have answered. Do gall-stones occur more commonly in the insane than in others, and is it possible for insanity to have any influence on the formation of biliary concretions?

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1892 

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References

“A Treatise on Gall-Stones,” by J. L. W. Thudichum, M.D., London, 1863, to which work I am indebted for other observations.Google Scholar

“Lancet,” April 2nd 1892.Google Scholar

“Principles and Practice of Medicine.” Philadelphia, 1873.Google Scholar

“Clinical Lectures on Diseases of the Liver,” 1885.Google Scholar

“Principles and Practice of Medicine,”edited by Pye Smith, Vol. ii., p. 504.Google Scholar

Thudichum.Google Scholar

Medical Society of London, I.c. Google Scholar

“Dictionary of Practical Medicine,” 1866.Google Scholar

“British Medical Journal,” Jan. 30, 1892.Google Scholar

l.c., p. 543.Google Scholar

“Chemical Physiology and Pathology,” 1891, p. 531.Google Scholar

“Lehrbuch der Physiologischen Chemie,” Olef Hammarsten, 1891.Google Scholar

“Physiology,” i., 147.Google Scholar

“Cholesterinis probably an ultimate product of certain tissue changes, which has to be got rid of, but whether it ia solely manufactured in the nervous system is not clear. In the blood it has been proved to exist in the red corpusoles, and not, so far as I know, in the fluids of the blood. Seeing that the red discs are incapable of taking up and conveying a substance such as cholesterin from one part of the body to another, and as the difficult subject of the existence of this substance in the white corpuscles does not appear to have been worked out, it is impossible to say if any of the cholesterin in the bile is derived from the nervous tissues. It may be noted, however, that Drs. Noel Paton and Balfour consider that the cholesterin in the bile owes its origin entirely to the destruction of blood corpuscles, for in observations on the composition of human bile, they say, “In connection with the cholesterin and lecithin there can be little doubt that these are derived from the stroma of the red corpuscles. The vague view that they are derived from the nervous system, taught by certain physiologists, is based upon no better evidence than the fact that both substances occur in these tissues.” (“British Medical Journal,” May 7, 1892.) The former, writing again in the number for May 21st, says, “From the wellknown fact that an enormous destruction of h;emocytes goes on in the liver there is at least a fair basis for the view that the cholesterin and lecithin of the bile are derived from these constituents in the corpascles.” Whether this viewis correct or not, it raises an interesting question. In those persons in whom gall-stones occur, is there an excessive destruction of red corpuscles taking place in the liver by which not only the cholesterin, but also the pigment, ia increased in amount?Google Scholar

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