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JAMA. 1911;LVII(21):1690-1694. doi:10.1001/jama.1911.04260110190017.
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ETIOLOGY AND ENTRANCE  That the etiology of cholecystitis depends on bacterial infection is the generally accepted opinion; and it is believed that cholelithiasis may result from cholecystitis, and that cholelithiasis, having once become a condition or lesion, may then become a factor in the production of cholecystitis.While it is generally conceded that the portal circulation is the avenue of entrance, the bacteria may enter the common duct by way of the duodenum; or possibly through the hepatic artery and the lymphatics they may find their way to the biliary tracts. And while normally the liver acts as a toxin filter, yet, when overtaxed, its filtration must be but imperfectly accomplished, and the effects of this non-fulfilment of function in so important an organ as the liver are liable to be disastrous.

INFECTION  These etiologic infections may be mixed or simple; if mixed, one organism may prevail to-day and may


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