Getting (de)stoned for Thanksgiving

I confess, I’m not a huge fan of Thanksgiving in general, for a whole host of reasons. But this year, I do have one thing I’m very thankful for.

A side effect of writing historical fiction and reenacting is that I tend to “live” in the period I’m writing about. So when my dear adopted sister/roommate/cover artist Ash went in for gallbladder surgery this week, I couldn’t help but think about what the procedure would have been like in the 1800s. If it took her 5 years to get a diagnosis in the modern age, what would her chances have been like a hundred and fifty years ago?

By the 1700s, anatomists had identified the gallbladder, and knew that it could produce stones, but they didn’t know what caused this phenomenon, or even what, exactly, the gallbladder did.

The gallbladder is an organ attached to the liver, which helps with the processing of toxins in the body. Stones form when there’s too much cholesterol or bilirubin in the gallbladder (bilirubin is a substance that helps with the breaking down of waste products). They can cause pain or discomfort, but the real danger comes when they get stuck in the bile ducts, which can lead to an infection, which can set in very quickly. In the days before antibiotics, this could be very dangerous.

While it has been known since the 1600s that the gallbladder is a non-essential organ, this discovery by a pair of Italian doctors went largely unnoticed by the larger medical community until the late 1800s.

In 1867 the first procedure to remove gallstones was performed. This technique of cutting open the organ to remove the stones and inserting a drainage tube was the primary treatment for the problem until the 1880s, but it was not as effective as initially hoped. Patients still had a lot of pain, were open to infection, and the stones could return.

In 1882, a 27-year-old German doctor, Carl Johann August Langenbuch, frustrated by the shortcomings of this procedure, conducted his own experiments until he, too, came to the conclusion of the Italians: the gallbladder was not a necessary organ, and could be safely removed. His technique reined as the standard for more than a hundred years, until another German, Erich Mühe, pioneered the modern laparoscopic method in 1985 which uses a small camera to aid in the surgery, making the incisions smaller and the overall procedure faster and safer.

Today, it’s a very common, very safe procedure, and the 8th most common surgery in the US, and still the most effective method for treating gallstones.

Maybe that’s something we should keep in mind today, the day after American Thanksgiving–which my office calendar has helpfully labeled “Indigestion Day.”

Further Reading:


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