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Editorial.

Editorial Notice. Owing to the fact that the Editor is ab sent, taking a complete rest, there will be no editorials in this issue.

(Written for the MEDICAL BRIEF.) Early Surgical Interference In Gall

Bladder Disease.

of as “autopsies in vivo,” unsuspected conditions found in operations, instead of knowledge derived from the post-mortem table. We are learning to make explora. tory operations for conditions that may be relieved long before it becomes so serious as to suggest a post-mortem. A distinguished member of our profession, in a neighboring city, suffered for nearly twenty years with what he supposed to be attacks of dyspepsia, or indigestion, as he called it, more or less severe. The suggestion having been made that there might be a gall-bladder disease, an operation was resorted to, and a large number of unsuspected stones were found in the gall bladder; the gall bladder was thick. ened and eroded, there was a fistulous opening between the gall bladder and the duodenum. Cholecystectomy done, the hole in the duodenum was sewn up, and he has for the last two years enjoyed health that he had not had for the previ. ous twenty years.

We must learn to operate before these conditions exist, if possible, and the early symptoms of gall-bladder disease studied with more acuity than heretofore.

BY WILLIAM H. CARMALT, M, D., Professor of the Principles and Practice of Sur

gery in Yale University; Fellow of the American Surgical Association; Member of the American Medical Association; Secretary of the Congress of American Physicians and Surgeons, Etc., Etc., New Haven, Conn.

A few years ago surgeons operated only for suspected or assumed stones in the gall bladder and ducts. Investigations of this subject have brought to light a number of conditions which require sur. gical intervention, our knowledge of them having been derived by what Kehr speaks

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