90 



PRODUCTS, ADVENTITIOUS. 



has described a concretion found in the tho- 

 racic duct. The lymphatics of the small in- 

 testines have been found in this condition by 

 Walther.* 



The lymphatic glands, especially the bron- 

 chial and mesenteric, are, however, not unfre- 

 quently the seat of calcareous precipitation in 

 points, patches, or through their entire sub- 

 stance ; it chiefly occurs in connection with 

 tuberculous disease. 



(f.) Serous and synovial cavities. These 

 cavities occasionally contain calcareous pro- 

 ductions, evidently produced by the deposition 

 of saline matter in a pre-existing organic 

 basis. This basis, commonly effused fibrin 

 (when the concretion has been free from the 

 moment the process of saline deposition com- 

 menced), has in other instances been the sub- 

 stance of fibrous tumours once attached be- 

 neath the serous membrane, and accidentally 

 set free. 



(g.) Similar bodies are occasionally found 

 in connection with the fibrous membranes. 

 Andralf describes a very interesting case of 

 tumour of this kind attached to the tentorium 

 cerebelli. 



(h.) Cerebral. A concretion taken from 

 the brain analyzed by Lassaignef was found 

 to be composed almost wholly of fibrin, of a 

 small quantity of cholesterin, and of 4 per cent, 

 of phosphate and carbonate of lime the evi- 

 dent, though rare, result of previous haemor- 

 rhage. A concretion from the cerebellum, exa- 

 mined by Simon , about the size of a nut, of 

 irregular angular form, very solid, both inter- 

 nally and externally resembling a piece of bone, 

 and enveloped in a fine coriaceous capsule, con- 

 sisted principally of phosphate and carbonate of 

 lime with a little cholesterin. A similar concre- 

 tion analyzed by John consisted of 75 parts of 

 phosphate of lime and magnesia, and 25 of 

 animal matter ; another examined by Morin 

 was composed of cholesterin, coagulated albu- 

 men, and earthy phosphates. 



(/.) Uterine. Much confusion has arisen 

 from want of accurate distinction of the diffe- 

 rent kinds of saline deposition occurring in the 

 uterus. These kinds, we hold to be, three in 

 number. 1. The internal mucous surface 

 may be coated with phosphatic salts. 2. The 

 parenchyma of the organ may contain " ossi- 

 form " (really calcareous) globular masses re- 

 sulting from the deposition of saline matter 

 in the interior of fibrous tumours. 3. The 

 uterine tissue may be the seat of phosphatic 

 accumulation around foreign bodies. These 

 bodies may be either introduced (a) from with- 

 out, or (b) enter the uterus from some other 

 part of the genital system. () Of the former 

 case Brugnatelli records a curious instance. 

 A calculus weighing about two ounces, of 

 rough surface, and composed of phosphate of 

 lime, was removed from the uterus of a young 

 peasant, and on division found to have a small 



* Mem. cle 1'Acad. des Sciences dc Berlin, 178G- 

 87, p. 21. 



f Cl. Me'd. t. v. p. 8. 



j Journal dc Chim. Mod. t. i. p. 270. 



Loc. cit. p. -171. 



piece of the tibia of a fowl for its nucleus, 

 broken off, no doubt, from the entire bone, 

 which had been introduced per vaginam, for the 

 purpose of inducing abortion. (A) Fragments 

 of foetus derived from extra uterine pregnancy, 

 as also moles and hydatids, occasionally form 

 the nucleus or basis of saline concretions. 



The Fallopian tubes, too, sometimes contain 

 calcareous concretions. Walther had in his 

 possession a globular calculus of yellowish co- 

 lour, a third of an inch in diameter, weighing 

 ten grains, taken from the left Fallopian tube 

 of a woman aged forty. It is extremely pro- 

 bable, though not proved by examination, that 

 these masses are, in some instances at least, 

 the remains of fibrous tumours. 



(/f.) Pulmonary concretions. The pulmo- 

 nary parenchyma is an extremely frequent seat 

 of concretions. The basis, in which the saline 

 material accumulates, is by far the most fre- 

 quently tuberculous ; more rarely the fibrinous 

 substance of simple inflammatory exudation 

 forms its nidus : numerous points of interest 

 are connected with these kinds of concretions, 

 and will be more fully referred to in the section 

 on tubercle. Cancerous substance in the lung 

 may become locally infiltrated with saline sub- 

 stances ; we have not known such change to 

 occur in blood effused in this parenchyma. 



The appendages of the lung are likewise 

 among the habitats of concretions. Fibrinous 

 exudations in the pleura occasionally form the 

 basis for simple saline precipitation ; or less 

 frequently of an ossification-process. The 

 bronchi become in very rare instances more or 

 less completely blocked up with solid concre- 

 tions, the organic basis of which, in the majo- 

 rity of instances, is not improbably (but this 

 point requires further investigation) that mate- 

 rial holding a medium position between diph- 

 theritic deposit and common inflammatory 

 exudation matter, which constitutes the anato- 

 mical character of " plastic bronchitis." In a 

 case observed by Gorup-Besanez*, such, how- 

 ever, could not have been the origin of the 

 saline accumulation, at least presuming the 

 chemical analysis to have been correct. Here 

 a coral-like " ossification " was found in the 

 bronchi of a man aged forty-five, as thick as a 

 crow's quill, and extending through the whole 

 length and breadth of the lungs. It broke 

 with a crack ; whether it was hollow or not, 

 we are left to conjecture. On analj'sis it 

 furnished 



Fatty matters and traces of soluble 

 salts 17.17 



Mucus 32.46 



Phosphate and carbonate of lime, 

 with traces of oxide of iron .... 50.37 



(/.) Arthritic. The substances termed 

 tophi or gouty concretions belong to the pre- 

 sent class. Variable in shape, rounded or 

 tuberculated ; of yellowish white or brownish 

 red colour externally, internally white ; vary- 

 ing in consistence from soft toughness to very 

 considerable hardness; sometimes unctuous 

 to the feel; and apparently enveloped in a 



* Heller's Archiv. Feb. 184G, or Medical Times, 

 1316 ; also Tice, in Med. Chir. Trans, vol. xxvi. 



