PROGRESSIVE OBSTRUCTIVE JAUNDICE

Abstract

In 1618, according to Thudichum,¹Johannes Fabricius removed gallstones from the gallbladder of a living subject. Fabricius Hildauus refers to this operation in his "Surgical Observations," but it is not clear whether the operation was premortem, as the only evidence of the subject's being alive is the somewhat dubious expression "delineatio horum lapidum ad vivum facta." No such shadow hangs over Petit's²first project. During the decade beginning with 1733 he discussed boldly and with great acumen tumors of the gallbladder and the sequences of biliary obstruction. From these papers and the discussion which arose over them he emerged as the founder of gallbladder surgery, his description of symptoms and outlines of operative procedures remaining classic. Neither Petit nor Thudichum, who wrote with equal insight a century and half later, failed to evaluate the difficulties of gallbladder surgery excepting one. Neither mentioned the hemorrhagic tendency in obstructive jaundice