This work is based on experience with 908 patients with disease of the gallbladder who were treated medically during the past ten years. Rehfuss and Nelson, however, give no analysis of data as to the results of such treatment or as to its individual elements. One hundred and twenty pages are devoted to the diagnosis of cholecystitis, much emphasis being placed on the results of duodenal intubation and cholecystography in diagnosis and in observation of the course in the patient under treatment. The catalog of symptoms described as suggesting cholecystitis leaves one with the impression that various other conditions, mostly functional, may have been included by the authors under the class of mild cholecystitis, and this perhaps helps explain their enthusiasm for medical treatment.
The authors feel that the present knowledge of the physiology and pathology of the biliary tract justifies outlining a system of treatment which would be on