URINE. 



1287 



To this table Dr. Front appends the fol- 

 lowing valuable remarks in his work " On 

 Stomach and Urinary Diseases " : 



" In this table the urinary calculi contained 

 in the museums of" Bartholomew's and Guy's 

 Hospitals in London, and of the provincial 

 hospitals of Norwich, Manchester, and Bris- 

 tol, are contrasted with the calculi existing in 

 Svvabia in Germany, and in Copenhagen in 

 Denmark. The data here collected are too 

 limited to throw much light on the relative 

 prevalence of calculous affections in different 

 parts of England, much less in England as 

 compared with the different countries of Eu- 

 rope ; yet in other points of view, and par- 

 ticularly in demonstrating the relative pre- 

 valence of the different species of calculi, and 

 the order of the succession of the different 

 layers of which calculi are composed, &c., 

 they are highly interesting and important. 



" In this table, the whole of the data com- 

 prising the analysis of 1520 calculi, are col- 

 lected into one point of view, under the 

 general heads of I. Litf/ic ac/d, 2. Mulberry, 

 2. Cystic oxide, 4. Pkospliatic, 5. Alternating, 

 and 6. Compound Calculi. 



" On each of these heads we shall make a 

 few remarks. 



"1. Of lit/tic acid calculi. The proportions 

 of pure lithic acid calculi to the whole num- 

 bers contained in the different museums, are 

 as follow : In Bartholomew's Hospital, as 

 1 : 11^-; in Guy's Hospital, as 1 : 5+ ; in 

 the Norwich Hospital, as 1 : 4+ ; in Swabia, 

 as 1 : llf ; in Copenhagen, as 1 : 5 . The 

 relative proportions of pure lithic acid calculi 

 in the Manchester and Bristol Museums are 

 not mentioned ; hence, abstracting the Man- 

 chester and Bristol, the general proportion of 

 pure lithic acid calculi is as 1 ; 6|, nearly. 



" The relative proportions of calculi in the 

 different museums, composed essentially of 

 lithic acid, (i. e. consisting of pure lithic acid, 

 lithate of ammonia, and the latter ingredient 

 mixed with minute quantities of the lithate 

 and oxalate of lime, and the phosphates,) are, 

 in Bartholomew's Hospital, as 1 : 7 ; in 

 Guy's Hospital, as 1 : 4 ; in the Norwich 

 Hospital, as 1 : 3+ ; in the Manchester 

 Hospital, as I : 2i + ; in the Bristol Hos- 

 pital, as ] : 3 ; in Swabia, as 1 : 10+ ; and 

 in Copenhagen, as 1 : 4| . The general 

 proportion in all the collections is as I : 3 . 



" If we take into account all the calculi of 

 which the lithic acid or its compounds form 

 the nucleus, the proportions of calculi originat- 

 ing with this principle (and which probably 

 would otherwise have not been formed) is 

 very much greater. Thus in Bartholomew's 

 Hospital the proportion of calculi containing 

 the lithic acid or some of its compounds as a 

 nucleus, is to the whole number of calculi as 

 ] : If ; in Guy's Hospital, as 1 : 4 , (not 

 fairly comparable, as the calculi do not appear 

 to be divided ;) in the Norwich Hospital, as 

 1 : 1^+ ; in the Manchester Hospital, as 

 1 : If ; in the Bristol, as 1 : 2+ ; in 

 Swabia, !:!+; and in Copenhagen, as 



1 : li. The relative proportions of all the 

 calculi originating in some form or combina- 

 tion of lithic acid, in all the different collec- 

 tions, is nearly as 1 : IA, which is equal to 

 saying, that if a lithic acid nucleus had not 

 been formed and detained in the bladder, two 

 persons at least out of three who suffer from 

 calculus would have never been troubled with 

 that affection. 



" Of mulberry or oxalate of lime calculi. 

 The proportions of mulberry calculi in the 

 different hospitals are nearly as follow : in 

 Bartholomew's Hospital, as 1 : 1G+; in 

 Guy's Hospital, as 1 : 4 ; in the Norwich 

 Hospital, as 1 : 31^ ; in the Manchester 

 Hospital, as 1 : 17; in the Bristol Hospital, 

 as 1 : 6f ; in Swabia, as 1 : '27 ; in Copen- 

 hagen there does not appear to be any cal- 

 culus composed throughout of oxalate of 

 lime ; but if we take the nearest approach to 

 such composition, in which calculi are com- 

 posed principally of this salt with a mixed 

 nucleus, likewise containing oxalate of lime, 

 the proportions will be as 1 : 19^ ; the 

 general proportions in all the museums are as 



" If we take into account all the calculi of 

 which the oxalate of lime constitutes more or 

 less of the nucleus, the proportions in the 

 different museums will be, in Bartholo- 

 mew's, 1 : 4|+ ; in Guy's, 1 : 4 ; in Nor- 

 wich, 1 : 7i+ ; in Manchester, 1 : 4+ ; in 

 Bristol, 1 : 3 ; in Swabia, I : 27 ; and in 

 Copenhagen, 1 : 2^+. The general pro- 

 portion of calculi, into the nucleus of which 

 oxalate of lime largely enters, in all the 

 museums, is as 1 : 4^-f ; which is equivalent 

 to saying, that if a mulberry stone had not 

 been formed and detained in the bladder, two 

 persons out of about nine who suffer from 

 calculus would not have been troubled with 

 that affection. 



" 3. Of cystic oxide calculi. Of this rare 

 form of urinary calculus, four out of the seven 

 museums contain no specimen. Calculi of 

 this substance exist in the museums of Bar- 

 tholomew's, Guy's, and the Manchester Hos- 

 pitals, amounting altogether to five only. 

 Hence the general proportion to the whole 

 number of cystic oxide calculi examined, is 

 only as 1 : 304. 



" 4. Of phospliatic calculi. Calculi com- 

 posed throughout of the phosphates are com- 

 paratively of uncommon occurrence; while 

 calculi consisting externally of the phosphates, 

 as will be presently shown, are the most fre- 

 quent of all others. At present we have to 

 do with calculi composed essentially of the 

 phosphates. 



" The proportion of calculi composed of the 

 phosphate of lime, in Bartholomew's Hospital, 

 is as 1 : 32% ; in Guy's Hospital, as 1 : 29 ; 

 in the Norwich Hospital, as 1 : 132f ; in the 

 Bristol, as 1 : 155. The other museums 

 contain no specimen. The general proportion 

 of phosphate of lime calculi, to the whole 

 number, is as 1 : 117 . 



" The proportion of calculi composed of the 



4 N 4 



