CHOLECYSTECTOMY AND CHOLECYSTIC TOXEMIA

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Abstract
According to the mode of invasion, gallbladder infections may be divided into four types: Portal infection, in which bacteria entering the portal circulation, chiefly from the alimentary tract, escape the bactericidal action of the liver and passing out with the bile, colonize in the gallbladder. This method, described years ago by Adami, has been considered as quite common and is supposed to explain the relationship between appendicitis, intestinal ulceration and other inflammations of the alimentary tract and gallbladder disease. Ascending biliary infection, in which bacteria ascend from the ampulla of Vater through the common and cystic ducts and enter the gallbladder. This process is aided by the reversed mucous currents described by Bond, who showed that carmine particles introduced even as low as the rectum would after a time pass upward against the normal peristaltic current, and be discharged on the surface of the skin through a cholecystostomy opening. Although

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