Vieussens, the celebrated anatomist, reports an instance in which
the liver weighed 20 pounds, and in his "Aphorisms," Vetter cites
a similar instance. In 1811 Kraus of Germany describes a liver
weighing 25 pounds; modern instances of enlarged liver are too
numerous to be quoted here.
Rupture of the gall-bladder, although generally followed by
death, is not always fatal. In such cases bile is usually found
in the abdominal cavity. Fergus mentions a case in which, after
this accident, the patient was considered convalescent and was
walking about, when, on the seventh day, peritonitis suddenly
developed and proved fatal in two days. Several cases of this
accident have been reported as treated successfully by incision
and drainage (Lane) or by inspiration (Bell). In these cases
large quantities of bile escaped into the abdominal cavity.
Peritonitis does not necessarily follow. Cholecystotomy for the
relief of the distention of the gall- bladder from obstruction of
the common or cystic duct and for the removal of gall-stones was
first performed in 1867 by Bobbs of Indianapolis, but it is to
Marion Sims, in 1878, that perfection of the operation is due. It
has been gradually improved and developed, until today it is a
most successful operation.
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