CHOLECYSTITIS. A very bad morphine habit had been picked up through the years of pain, and the eradication of this was even harder to accomplish than the involution of the stone. He was constipated but relied on laxatives for relief, so deepening the atonic state of the colon continually, through frequent false stimulation and its resultant enervation.

I often wonder if anyone has even seen a case of cholecystitis that did not show the colon bacillus, with the usual pus generators. In forty-eight years or practice. I have seen no case that did not point to its origin in the putrefying and fermenting contents of this ordinarily foul sewer, the colon.

In dealing with this subject it is well to remember that the gallbladder is merely a convenient reservoir for the accumulation and storing and distribution of bile, and so far as is known no other function is demonstrable. Yet it is most convenient storehouse or sulsus for this purpose, and without it the bile would fail to function as was plainly intended by nature.

With the arrival of fats in the duodenum there is a contraction of the gallbladder, forcing out bile to begin the emulsification of this fatty material, the larger the amount of fat the greater the amount of bile extruded. Fats cannot be properly saponified and prepared for absorption till they have been first quite completely emulsified, and as this emulsification can be accomplished only by the bile, it becomes evident that without a sufficiency of bile most fatty material must escape absorption and metabolism, so lost as nutritive material.

The fact that one can live without the gallbladder is no evidence that its presence is not essential to perfect nutrition, for one can also live without a kidney or appendix, but not so fully or completely. Surgery is not justified in treating the gallbladder so lightly as is usual, for to extirpate this title sac is to place a permanent handicap on fatty digestion for the life of the patient. So far the only effect is to stimulate a little more respect for the gallbladder and to point to the origin of its troubles as the colon in every case.

Considering the fact that all materials except the fats absorbed from the small and large intestines must pass through the liver, via the portal circulation, it becomes easy to connect colon states or conditions with the various ailments of the liver and its ducts, including the gallbladder.

All know the intimate connection between colitis in its various forms and abscess of the liver, due to the facts recited. The chief function of the liver is an elaborator of materials delivered to it through the portal system of veins, and if it were not for this organ we would not survive the daily intoxication of the usual colon for more than a very few short hours, as has been demonstrated in the laboratory animals, by short-circuiting the portal circulation, allowing it to go direct into the general circulation by means of a by-pass. In every case convulsions and death resulted so promptly that it left no doubt of the essential function of the liver as a filter, whatever else may be its duties.

The tropical infections that result in liver abscess show first as a colitis, the toxic material developed there in all cases being the direct cause of the secondary infections of the liver, consequently of the gallbladder.

The toxins intercepted by the filter function of the liver are turned out into the bile ducts, there to contact the lining membranes of the gallbladder and bile ducts, and their breakdown is not surprising.

Since the colon is so plainly the origin of the infections that attack the liver and gallbladder, it is necessarily to the colon that we look when we seek to remove the cause.

Many will remember the surgery of the colon advocated and practiced by Dr. Charles A. L. Reed, of Cincinnati, Ohio, in his search for the cause of epilepsy, and the almost as drastic surgery of Sir William Arbuthnot Lane, of London. The latter has stated that ninety per cent of all the diseases that afflict this frail human stem from the colon, and his colectomies did show recoveries in many conditions not seemingly related to the colon anatomically.

Yet the colon, like the gallbladder, is a most convenient organ, if its presence is not necessary to life, and the wholesale colectomies practiced by these men seem hardly justifiable by even considerably improved general states of health.

Fortunately the colon is so situated that its care is a simple matter without its removal, and it is possible to almost sterilize the organ in situ.

For the past thirty-three years, or since I have been confining all my work to correction of abnormal nutritional states, the number of infected gallbladders coming under direct examination and treatment has been very many hundreds, the percentage complicated by stone very great, yet their recovery has occurred with monotonous regularity, even stones disappearing in one or two years in every case except one, at the end of whose second year of dietary and colonic regulation stones still occupied the gallbladder, but reduced in size from that of a pigeons egg to the size of well developed peas, and most had been passed or disintegrated without colic, leaving but a half the original number. With this one exception every gallstone had disappeared within two years, and in but two cases was the involution of he stones complicated by colic.

W H Hay