NON-CALCULOUS CHRONIC CHOLECYSTITIS. Frequent unsuccessful desire to evacuate and when successful the patient expels only small quantities after each effort; weakness at the level of the inguinal regions. Spasms and rectal constriction. Loss of irregular action of peristalsis. Diarrhea alternating with constipation, especially after excessive use of cathartics or laxatives. Urgent defecation producing very intense pain throughout the abdominal region and small quantities of stool.

Those who say that they have put Homoeopathic medicine to test and that it is a failure, evidence their own ignorance- Aphorisms and Precepts-Dr. J.T.Kent.

Non-calculous chronic cholecystitis is an inflammatory process of the gall bladder, associated with inflammatory lesions of the same type of the intra- and extra-hepatic channels.

Because of its common occurrence, this ailment deserves extremely careful attention on the part of the physician. It is the consequence of acute inflammatory processes following septicemic, streptococcic, pneumococcic, scarlatinal and influenzal infections, small pox, malta fever, etc., etc. The Eberth bacillus is often found after several years in chronic cholecystitis.

Pregnancy is a factor producing cholecystitis. Various diseases of the digestive system are associated with this condition or are liable to produce it. Such are: chronic and acute appendicitis giving the Dieulafoy syndrome, lesions of the duodenum and the pancreas, intestinal parasitosis, such as amoebiasis, lambliasis and cholebacillus, the presence of which is constant in chronic cholecystitis.

Inasmuch as this trouble is one occurring in adults, women are more affected by chronic cholecystitis, and statistics show that 70 per cent of the patients are women, multiparous mothers especially, while the other 30 per cent are men.

The diagnosis of non-calculous chronic cholecystitis must be established on the following bases:

1st-Functional symptoms

2nd-General symptoms

3rd-Physical signs

4th-Radiological signs and

5th-Duodenal probe or the Meltzer-Lyon test.

FUNCTIONAL SYMPTOMS-Most frequently dyspeptic phenomena are found of a flatulent nature causing a sensation of a weight or gastric or intestinal distension, which symptoms become aggravated by the ingestion of foods abundant in cholesterin, fats and farinaceous elements. Exercise, violent trepidatory movements and emotional states aggravate these symptoms.

In the morning, before taking food, a frequent state of nausea and vomits of a bilious, mucous, exceptionally alimentitious type is observed. Pain localized in the epigastrium is present radiating to the gall bladder region and extending to the right or the left scapular region. There is at times a sensation of spasm in the esophagus as well as precordial pain and hyperchlorhydric phenomena.

The gastric pains bear no relation to the ingestion of food and vomiting does not produce any relief. The epigastric pain has a variable duration and it may be prolonged for two or three hours.

GENERAL SYMPTOMS-The patient has a bitter taste in the mouth, especially in the morning, anorexia and often Linossier’s post-prandial diarrhea characterized by intense pain in the transverse colon causing an abundant, fermented, liquid, bilious, fetid evacuation which produces immediate relief.

On other occasions there prevails a state of tenacious constipation of a spastic type, sometimes assuming the clinical form of “irritable colon”.

Evacuations are more or less discolored or acholic.

As a general rule, the patient is asthenic and progressively loses weight, which fact is accompanied by Dyspnoea on effort, tachycardia, extra-systoles, vertigo, violent temper. nervousness and insomnia. Dysmenorrhea and functional derangements of the ovary are frequent in women.

Right hemicrania ending in frequent vomiting and urticarial crises in their different types are associated manifestations of non-calculous chronic cholecystitis, Persistent febricula, bearing no relation to the meal hours, which may or may not be accompanied by marked chill, is another manifestation of this disease.

PHYSICAL SIGNS-Pain on pressure at the cystic site, at which exploration nausea and vomiting are usually produced. Saburral tongue, halitosis, conjunctiva and skin with frank subjaundice, acholic excrements. Enriquez’ or Murphy’s sign is positive.

RADIOLOGICAL SIGNS-Negative cholecystography, i.e. excluded for incapacity of concentration to coloring matter, but it should be noted that a normal image of the bladder does not exclude non- calculous chronic cholecystitis.

DUODENAL EXPLORATION-The Meltzer-Lyon test is meant to ascertain whether in non-calculous chronic cholecystitis there exists a process of infection of the gall bladder, and when the response is positive, the bile “B” extracted by probing presents

a greenish color due to the transformation by oxidation of the bilirubin into biliverdin under the influence of bacteria. The analysis of this bile reveals the presence of bacteria, mucus, albumin, pyocytes in greater or lesser quantities, depending on the inflammatory state of the bladder. But it should be noted that occasionally, in spite of the bladder being infected, the bile is thoroughly aseptic.

PROGNOSIS-The prognosis of non-calculous chronic cholecystitis is always serious, due in part to its chronicity and, on the other hand, to the frequent associations and stages of acuteness bearing on the liver and the pancreas, as well as on the general condition of the patient. Of the complications arising from non-calculous chronic cholecystitis, the most serious are: cholangitis, leading to suppuration of the bladder; hypertonic dyskinesia ending in vesicular stasis and predisposing to calculous cholecystitis, definite sclerosis of the bladder, atrophy of same, and vesicular hydrocholecystitis or dropsy.


The traditional medical school advises disinfectants of the biliary ducts, as well as cholagogue and choleretic medicaments and hydromineral cures, and as a heroic recourse, permanent duodenal probing for several days. When the desired results are not obtained, an operation is made performing cholecystectomy or cholecystotomy, as the case may be.

The Hahnemannian school has an extremely large number of medicaments which, being known under pure proving and now complemented by laboratory works, make manifest their elective action on the liver and the intra-and the extra-hepatic biliary ducts. The success of these remedies, duly prescribed, has been clinically demonstrated in the treatment of non-calculous chronic cholecystitis, under the law of Similia Similibus Curentur. The main remedies are:.

Chelidonium majus-Characteristic symptoms are: constant pain at the lower angle of the right scapula yellowish pasty tongue with teeth imprint, bitter taste, halitosis. Nausea in the morning or alimentitious or biliary vomit, pain in the vesicular region and epigastrium, which is temporarily relieved by eating.

Distention of the stomach and intestines with fermentations. Constipation with hard, small, round evacuations of a bright yellow color or clay color, acholic evacuations with alternate diarrhea and constipation. Pruritus ani. Turbid, foamy, dark yellow urine, beer-like in appearance.

Sclerotica and skin with sub-icteric tinge.

The patient is excited and irritable, with agitation and anxiety, and presents alternate irritability and depression. Vertigo and nausea, with the sensation of falling forwards. Right hemicrania that becomes aggravated when stooping, in the open air and at the slightest movement.

Chelidonium is adapted to people having blond hair , with ailments located on the right.

AGGRAVATION-In moving, when stooping, on weather changes, in the open air, at 4 in the morning or in the afternoon, on the right side.

RELIEF-After meals, by pressure and heat.

Podophyllum peltatum-People of an irritable temper with hepatic, vesicular, duodenal and left colon disturbances. Vertigo with a sensation of falling forward, right or left cephalalgia in the supra-orbital region, with bitter taste in the mouth, halitosis, rocking sensation in the head from one side to the other with desire to vomit and need for closing the eyes.

Epigastric pain with distention and sensation of vacuum in the epigastrium. Anorexia, longing for acid food, thirst for large amounts of water. Hyperchlorhydria with regurgitation of food. Morning vomiting, mucous or of a biliary type, yellow or greenish in color. Heat with burning sensation in the stomach. Intolerance to milk. Sensation of fullness in the right hypochondrium spreading to the transverse and descending colon, which becomes aggravated early in the morning causing matinal, painful, green, aqueous, too profuse, fetid diarrhea, expelled like a water jet.

At other times, the diarrhea is colorless or alternates with constipation, in which case defecations are acholic, hard and dry and expelled with great difficulty. These may or may not be accompanied by rectal prolapse. Rectocolitis with external or internal haemorrhoids. Rectal mucorrhea.

AGGRAVATION-Early in the morning, heat, after eating and drinking.

RELIEF-By friction and when the patient lies on the abdomen.

Carduus marianus- Elective action on the liver and the biliary ducts, mainly for patients who have used alcohol and beer in excess. Disturbances of sugar metabolism associated with diseases of the liver and pancreas. Bronchial asthma of an allergic type. Vertigo with backward falling. Heavy stupid head.

Bad or bitter taste in the mouth at all times. Aversion to meat or salty food. Nausea upon awakening, retching until green phlegm and a great amount of acid liquid are vomited. Congestive hepatitis, cholecystitis and angiocholitis, jaundice. A preventive of calculous cholecystitis.

Hilario Luna Castro