THE TIME ELEMENT IN GALLSTONE FORMATION

Although it is well known that small concretions can be produced experimentally in the gallbladder of laboratory animals within a period of a few days—ten days according to Klivert¹—and that small deposits of bile elements may occur around suture material within a few weeks after its insertion into the human gallbladder, yet conclusive proof concerning the rapidity with which well developed calculi may form in the human gallbladder is lacking. Rolleston ² quotes Mignot³ to the effect that it takes five or six months to form a stratified, well-formed biliary calculus. Moynihan⁴ cites a case reported by Rokitzski⁵ of a probably rapid formation of gallstones in a typhoid fever patient, aged 26, who was operated on at the end of the third week of her illness because of a suppurative cholecystitis. Fiftyeight apparently recently formed cholesterin calculi, showing a radiate arrangement, were removed. Cultures of