In this paper I have tried to bring before you the results of my experience in this field, mycredo, if you will, and to ask you to share with me certain beliefs that have, through many years, gradually crystallized in my mind and which have helped me in my attempt to attack this very difficult problem in the way that is best for patient and for doctor. I am sure that it is wrong to consider the gall bladder as a separate entity and not as a part of the entire biliary tree, although in a considerable proportion of cases, the major portion of the pathology is concentrated there and it is in this group of cases where surgical attack upon the gall bladder is likely to be most successful. I am convinced that, in analyzing the symptoms, we must determine how many are referable to the gall bladder itself, how many to liver, ducts and biliary tract, for on the results of such analysis, must rest our decision as to medical or surgical treatment; and, if the latter is decided upon, what is the best operative procedure? I am quite convinced that cholecystectomy is the operation of choice in the vast majority of cases in which surgery is indicated, and, that in a good many of these cases, complete relief may be obtained by the removal of the gall bladder. I am equally convinced that where there is evidence of extensive liver and biliary tract infection as well, it is far wiser, if surgery is to be done, to employ cholecystostomy, possibly followed later by cholecystectomy or cholecystogastrostomy. I have touched upon the physiological basis for medical and dietetic treatment and its simplicity and its success in a fair number of chronic cases if carried out conscientiously, but I have tried not to over-emphasize its value because surgery must be utilized in most of the severe and many of the milder cases. Finally (for after all what is the value of treatment if diagnosis is not correct?), I have tried to preach the doctrine of thoroughness in reaching one’s final conclusions as to the underlying pathology: I have insisted upon the absolute necessity of a careful history of the case as well as the utilization of all the laboratory methods at our command. I have pointed out the difficulties in diagnosis in this field because of the striking tendency of the gall bladder to mirror symptoms due to disease elsewhere and in turn to be the cause of referred symptoms. To me, this will always be a fascinating field, a field beset with many difficulties, a field in which often we must grope rather blindly for a while, but one which I feel sure will become easier and easier of exploration if we attack each individual case thoroughly and scientifically—without prejudice and without bias—and if we try to learn as much, or more, from our failures than from our successes.