52 OV THE STRUCTURE OF CALCULI. 



the bladder after death. Two of these I shall particularly 

 notice, because they were published during the patient's 

 life time in proof of the stone having been dissolved. 



Case illuitrat- Both patients were great sufferers from the symptoms of 

 * l$ ' stone for many years ; but when they arrived at the age of 



sixty-eight, or thereabout, the symptoms entirely left them. 

 The one had been taking the saline draught in a state of ef- 

 fervescence, under the direction of the late Dr. Hulme : the 

 cure was attributed to this medicine, and the case was pub- 

 lished in proof of its efficacy. When the patient died, I 

 examined the bladder, and found twenty calculi ; the largest 

 ©f the size of a hazel nut, the others smaller. It appeared, 

 that the going off of the symptoms had arisen from the pos- 

 terior lobe of the prostate gland having become enlarged (a 

 change which it frequently undergoes about that period of 

 life,) and having formed a barrier between the calculi and 

 the orifice of the bladder, so that they no longer irritated 

 that part either in the act of making water, or in the different 

 movements of the body, but lay in the lower posterior part 

 ©f the bladder without producing any disturbance. Their 

 number prevented the pressure from being great upon any 

 one part of the intestine immediately behind the bladder, 

 and their motion on one another rendered their external sur- 

 face smooth, and probably prevented their rapid increase. 



Awtliert The other patient was under a course of Perry's lixivium ; 



and when the symptoms went away, he published the case in 

 proof of the efficacy of that medicine in dissolving the stone. 

 I examined the bladder after death, and found fourteen cal- 

 culi ; the largest of the size of a nutmeg, the others smaller. 

 There was the same enlargement of the posterior lobe of the 

 prostate gland, and the calculi were exactly under the same 

 circumstances as in the former case. 



^n several cases 1° several cases, in which I have examined the body after 



«tonej not felt, death, calculi have been found enclosed in cysts, formed be- 

 tween the fasciculi of the muscular coat of the bladder, so as 

 to be entirely excluded from the general cavity, and there- 

 fore had not produced any of the common symptoms of 

 stone. I have seen in the same bladder, two, three, and even 

 four such cysts, each containing a calculus of the size of a 

 walnut* 



It 



