On Mechanism of Coagulation and Solidification of Gallstone Ingredients in Bile.

Although a number of theories are available on the mechanism of separation of gallstone ingredients from bile, nothing is practically known as to how the separated ingredients coagulate and solidify in bile to form gallstones. This paper presents a theory on coagulation in bile of gallstones on the basis of a series of experimental facts. An outline of the theory is as follows: The gallstone ingredients separated from bile first form stable lyophobic colloids, but the stability of the colloids is soon decreased by effects of inorganic electrolytes (electrostatic effect) and high-molecular-weight organic substances (electrostatic effect and bridging action) of bile and the colloids are deposited as flocks. The flocks then gradually solidify under the influence of various types of kinetic energies that are exerted by the organism and are ultimately transformed into solid gallstones. In support of this theory, gallstone-like concrements were actually produced in vitro using a suspension of human bile sediment consisting mainly of calcium bilirubinate. This theory may also be applicable, to some extent, to the coagulation mechanism of other substances separated from a colloidal solution in the living organism.