The basis for this paper is a series of fifty-seven cases of chronic gallbladder disease in young adults, operated on in the early stages of the disease, with no mortality. All of these patients have improved, and most of them have lost their symptoms. We have been particularly interested in the early manifestations of chronic cholecystitis. We have come to feel that, before our study of the series from which these cases were selected and before our study of the pathologic findings in these cases, we commonly missed the diagnosis of a surgical condition of the gallbladder until the patient was in the late stages of gallbladder disease. We find that, as our cases have multiplied, we have been making the diagnosis of chronic cholecystitis earlier, and with increasing confidence.
These fifty-seven cases were selected after a restudy of a larger series of obscure cases presenting persistent abdominal symptoms, all