The gallbladder is a small pear-shaped organ located beneath the liver on the right side of the abdomen. The gallbladder’s primary functions are to store and concentrate bile and secrete bile into the small intestine at the proper time to help digest food. The gallbladder is connected to the liver and the small intestine by a series of ducts, or tube-shaped structures, that carry bile. Collectively, the gallbladder and these ducts are called the biliary system.
Gallstones may make their way out of the gallbladder and into the cystic duct, the channel through which bile travels from the gallbladder to the small intestine. If stones become lodged in the cystic duct and block the flow of bile, they can cause cholecystitis, an inflammation of the gallbladder. Blockage of the cystic duct is a common complication caused by gallstones.
The most common symptom of gallstones is episodic attacks of abdominal pain, most often located in the right upper abdomen but also can be felt in the back and right shoulder. Other symptoms include nausea, vomiting and intolerance to fatty foods. Gallstone pain (biliary colic) is usually caused by the gallbladder contracting in response to a fatty meal and pressing the stones against the gallbladder outlet (cystic duct opening) causing it to be blocked. As the gallbladder relaxes, several hours after the meal, the stones often fall back from the cystic duct and the pain subsides. Recurrent cystic duct blockages can progress to total obstruction causing acute inflammation of the gallbladder (acute cholecystitis), a serious condition which is associated with fever and requires immediate medical attention. Other complications may result if the gallstones migrate through the cystic duct and block the common bile duct causing jaundice, a yellow discoloration of the skin and eyes. It may also lead to infection of the bile ducts (acute cholangitis) causing pain, chills, and fever. Acute inflammation of the pancreas (pancreatitis) may also occur. If the bile duct remains blocked for a long period of time, irreversible liver damage may occur.
Three hundred Cayce readings are indexed as cholecystitis, an indication that this was a common problem during Edgar Cayce’s era. These readings provide wide variety of etiological factors and treatment options. Poor dietary habits and underactive (torpid) liver are primary contributing factors in gall bladder dysfunction. Therapeutic options for gallbladder dysfunction include: improved diet, internal cleansing (via colonic irrigation, laxatives, and castor oil packs), manual therapy (including osteopathic drainage of the gall duct), mild electrotherapy, and medicines to improve digestion and cleanse the gall bladder. Edgar Cayce sometimes recommended surgery for acute cases of cholecystitis involving high fever and inflammation. Otherwise, the readings generally advised a slower, safer process for healing the gallbladder using the modalities listed above. Although surgery is much less of a hazard than during Cayce’s era, some people report residual effects which may be linked to the absence of the gallbladder.
SCALE 23: GALLBLADDER DYSFUNCTION
|Pain along right rib cage, right shoulder or arm, or upper right back||3901-1, 3679-1, 2899-1, 1810-3, 1810-2, 1563-3, 1446-5, 313-17|
|Constipation||4631-2, 3901-2, 1688-3, 557-5, 356-1|
|Nausea||5408-1, 5060-1, 4631-2, 4299-2, 3358-1, 3160-1, 2665-3, 2278-1, 1688-3, 1688-1, 1446-5, 1343-4, 1312-5, 1151-31, 1060-1, 1010-1, 635-6, 623-3, 557-5, 555-6, 379-9, 379-7, 294-22, 60-1|
|Headaches, especially after eating||5738-1, 5734-1, 5449-4, 5060-1, 5024-1, 4982-1, 4299-2, 3901-1, 3358-1, 3092-1, 3048-1, 2899-1, 2665-3, 2641-2, 2434-3, 2278-1, 2078-3, 2078-1, 1964-2, 1857-1, 1745-5, 1663-4, 1532-3, 1429-1, 1331-1, 1010-20, 635-3, 555-6, 294-184, 294-22|
|Fever||5620-1, 5408-1, 5186-1, 4299-2, 3092-1, 2841-1, 1857-1, 1568-6, 1331-1, 1312-5, 1196-16, 1151-31, 1060-1, 852-18, 608-14, 379-9, 379-7, 294-199, 60-1|
|Intolerance to fats or greasy foods||5290-1, 5092-1, 5060-1, 4064-1, 4012-1, 3901-1, 3680-1, 3679-1, 3677-1, 3160-3, 3160-1, 3092-1, 2899-1, 2853-1, 2841-1, 2563-1, 2434-3, 2085-6, 1964-2, 1960-1, 1903-1, 1810-3, 1810-1, 1747-4, 1692-1, 1631-1, 1568-6, 1563-3, 1506-2, 1446-5, 760-21, 555-6, 356-1, 313-17, 294-201, 243-33|
|Bad breath or bad taste in mouth not directly due to food or drink||5092-1, 3372-1, 3092-1, 2085-6, 2078-1, 1810-1, 684-2, 635-5, 635-4, 555-6|
|Brown, yellow, or gray colored skin or brown splotches on skin||4012-1, 3358-1, 2563-1|
|Dizziness||2853-1, 2563-1, 1747-1, 1506-2, 1196-4, 1196-1, 1080-2, 635-5|
|Abnormal pulse (quick, slow, or irregular)||5620-1, 4631-2, 4064-1, 3160-3, 3092-1, 2641-2, 1810-1, 1563-3, 1415-1, 1312-5, 1010-15, 1010-7, 356-1, 336-1, 313-17|
|Shortness of breath||5060-1, 5024-1, 3523-1, 1830-1, 1331-1, 1196-1, 760-20, 623-3, 356-2|
AN OSTEOPATHIC PERSPECTIVE ON GALLSTONES
(NOTE: The following excerpt comes from The Practice and Applied Therapeutics of Osteopathy byCharles Hazzard, D. O., published in 1905)
DEFINITION: Concretions in the gallbladder, chiefly of cholesterin, due to a pathological process usually caused by spinal lesion to sympathetic nerves in charge of liver functions.
CASES: Very numerous cases of gallstones, some of gallstones, some of them noted, have been successfully treated. It is one of the most common things treated, and in no class of cases have more uniformly good, even striking, results been attained.
Doubtless, he could not avail himself of these detailed facts to manipulate at will the activities of the biliary apparatus, but spinal and other lesions affecting the sympathetic connections of the organs must be efficient causes in producing abnormal function. Osler states that any cause, such as tight lacing, bending forward at a desk, enteroptosis, etc., which produces stagnation of bile favors cholelithiasis.
From an osteopathic standpoint, and in view of the above facts, it is a reasonable conclusion that certain spinal lesion, acting through this nerve mechanism above described, may cause a stimulated, irritated, or overactive condition of the dilator fibers of the ducts and gallbladder, thus maintaining a permanent dilated or sluggish condition of the
apparatus, favoring stagnation of the bile and the formation of gallstones. Likewise one must concede the possibility of the lesion to the central end of the vagus nerve, cutting off the normal impulses through the nerve which contract the gallbladder and relax the sphincter of the common duct, thus allowing for a lack of normal contraction of the bladder and opening of the duct; in other words, favoring a sluggish condition of the biliary apparatus leading to retention and stagnation of bile, thus to cholelithiasis. If any osteopathic spinal lesion can interfere with sympathetic visceral supply, a point placed beyond controversy by demonstrated facts, it is a reasonable conclusion that spinal lesion to the sympathetic supply to the liver can become the cause of gallstones in this way.
According to the catarrhal theory of the formation of gallstones, lithogenous catarrh of the mucosa of the bladder and duct modifies the chemical constitution of bile and favors the deposition of
cholesterin about some nucleus, such as epithelial debris. Cholesterin and lime salts are produced by the inflamed mucous membrane to form the calculus. As shown above, both the hepatic and portal blood supply is under control of the hepatic plexus, i. e., of the solar plexus and the splanchnics. According to the American Textbook of Physiology, stimulation or inhibition (section) of the splanchnics produces at once vaso-constriction or vaso-dilatation of the blood vessels of the liver. Here, as in the case of gastric or intestinal catarrh, spinal lesion to the splanchnics could disturb vaso-motor equilibrium in the liver and cause catarrh of the mucous membrane. It is the practice of Osteopaths to give close attention to the condition of the spleen in case of gallstones.
The former is palliative treatment; the latter is the real cure. In the acute case, if colic is present the first step is to make strong inhibition over the 7th to 10th
spinal nerves. (Some say upon the right side). This will lessen or stop the pain, and allow of work on the abdomen. This is deep, relaxing inhibitive work upon the tensed abdominal walls, over the epigastric and lower anterior thoracic regions, and over the course of the duct. The pain, which is due to inflammation of the mucosa of the duct and to the rotary motion of the
stone, which is given this motion by the spiral arrangement of the Heisterian valve within the duct, is usually relieved in a few minutes. The stone is removed by working it along the duct after the preliminary relaxing treatment. The patient should lie on his back with knees flexed and shoulders slightly raised.
The lower ribs are raised, by inserting the fingers beneath their anterior edges, and manipulation is made deeply over the site of the fundus of the gallbladder (tip of 9th rib) and down along the course of the duct. The latter may vary from its course on account of sagging of the intestines sometimes found. This treatment must be thorough and persistent. It should be firmly and deeply, but most carefully applied. Sometimes a few minutes of work will pass the stone, but often continued treatment for three-quarters of an hour or an hour be devoted to it. Only careful manipulation could be borne by the patient for this length of time. As long as the stone remains in the duct and causes the colic the attempt to remove it should be continued, though it may not be advisable to treat it continuously all of the time.
The stone may or may not be large enough to be felt in the duct. Stones are often passed without pain. Some stones are soft and maybe carefully broken down by the treatment.
The spleen is treated by careful abdominal work over and beneath the lower left ribs, anteriorly. It is chiefly affected by treatment to the splanchnic, raising the lower left ribs (8th to 12th), and
removal of lower spinal and rib lesions.
Jaundice, if intense, indicates the impaction of the stone in the common duct. Its cure depends upon the removal of the stone. The kidneys should be kept active. Fever, if present, is allayed in the usual manner. Fatal syncope sometimes occurs. If imminent, the patient should be fortified against it by thorough stimulation of the heart. For obstruction of bowel by calculi, see Intestinal Obstruction.