illusions propagated by compilers have been dispelled, and diagnosis, I hope, has been made much more certain and easy. The rules for the treatment of gall-stone disease which I have given, although in their active or positive part they do not greatly differ from those observed hitherto, are decidedly negative in relation to certain energetic measures which up to the present time have been deemed applicable and useful in this disorder. While only a small number of these rules emanated from my own experience, all have in their turn been confirmed by it in cases which I attended either alone or in consultation. The treatment of biliousness-the disease which produces the casts of the bile-ducts and results in gall-stone disease, not the chimera which serves as the scape-goat of minds which are susceptible of satisfaction by a name without meaning-remains an open question until its symptoms are better ascertained and distinguished. The collection of illustrative cases given at the end of the treatise every reader will be able to enrich for himself from his own experience. The portrait of the mind of the Medical Society of London, as it exhibited itself in the age the representatives of which are now gradually passing away, was added as a standard of comparison for later enunciations or discussions to come. As the literature of France had been examined with such great care by Fauconneau-Dufresne, I believed myself justified in relying upon his treatise for that part of my materials which was not easily accessible to me. What he had failed to supply from German sources I endeavoured to furnish directly, and to record in substance or by reference. Special regard I paid to the literature of this country, and I believe that I have embodied accounts or notices of all the more important original observations contained in special treatises or periodical publications. But for the kindness of friends who from time to time assisted me by the contribution of specimens many valuable points could not have been ascertained. Pre-eminent among these generous contributors stands Mr. Silas Palmer of Newbury, who, in aid of the furtherance of researches of which he had read some accounts in the British Medical Journal,' transmitted to me, then a stranger to him, a box full of the most valuable calculi-the result of the assiduity and attention which he had been enabled to pay to postmortem examinations during the earlier years of his career. To Mr. T. Holmes I am indebted for the important specimens which contained the casts of the biliary ducts. Dr. Wilks kindly collected for me much human bile; and to the pepper-corn calculi sent by him to me the manes of Richard Powell are indebted for a restitution of rights of originality and competence which before had been denied to them. My friend, Dr. B. W. Richardson, contributed the liver of a patient who had died during the transit of calculi through the biliary ducts. Most particularly am I indebted and thankful to the librarian of the College of Surgeons, Mr. Chatto, who by his kind assistance made agreeable the sometimes irksome task of searching books of all ages, sizes, and conditions. JANUARY, 1863. J. L. W. THUDICHUM. |