XIV, 5 Padua: Cystolithiasis with Dietetic Deficiency 485 
Composition of layers. 
——. es Pc ala te ee 
Constituent. 
Layer. 
Chief. Minor. 
Cortex and second layer_______ Amorphous and triple phos- | Calcium carbonate and trace 
phate. of calcium oxalate. 
Third and fourth layers ______- Amorphous phosphate _____._. Calcium oxalate, calcium car- 
bonate, and ammonium 
; urate. 
WUGRIBVOR co os ccc Amorphous phosphate -_______ Do. 
PUUGIOUS «255 sons ec se Calcium oxalate ......-._.._... Amorphous phosphate and 
trace of uric acid. 
CASE 9 (GROUP II) 
E. M. (37388), 18 years old, single, female, Filipino, student; born and 
living in Santo Tomas, Batangas; admitted to hospital July 26, 1915, 
complaining of painful, frequent, difficult, and scanty micturition, and pus 
discharge occasionally. The condition is of about six years standing. No 
history of past diseases nor of beriberi. She is moderately developed but 
poorly nourished. 
Clinical diagnosis——Cystolithiasis, chronic cystitis, and prolapse of the 
rectum. : 
Urine analysis.—Reaction, alkaline; sugar, negative; albumin, a decided 
trace. Microscopic, abundant pus cells, some blood and mucus. 
Cystolithotomy was performed August 8, 1915; the patient was dis- 
charged September 2, 1915. 
Calculus analysis (one white wregular stone). 
: Grams. 
Whole calculus 31.5 
Portion analyzed 15.1 
Cortex, analyzed portion 5.5 
Second layer 5.2 
Third layer 4.0 
Nucleus 0.4 — 
Weight by calculation. 
Grams. 
Whole cortex 11.5 
Whole second layer 10.9 
Whole third layer 8.3 
Whole nucleus 0.8 
: Composition of layers. 
“2 
Constituent. 1 
Layer. : 
Chief. Minor, 
Cortex. Triple and amorphous phos- | Calcium carbonate and am- 
phate. monium urate. “ 
Second layer (brownish | Amorphous phosphate and uric | Ammonium urate and cystine. 
white). acid sete ie 
Third layer (brown) .....__.__-| Calcium oxalate ___._._...__. .. | Amorphous and triple phos- 
phate. 
Nucleus -------+...-.----------| Triple and amorphous phos- | Uric acid, ammonium urate, 
phate. and calcium sulphate, 
