Dr. Venables on the Cystic Oxide, &c. 37 



concreted, not being of very high specific gravity, — in a state 

 of minute or impalpable mechanical division its specific gravity 

 will scarcely exceed that of the urine ; it will remain in 

 suspension and be evacuated with this fluid. But if the 

 specific gravity of the urine be low, and the quantity of oxide 

 secreted relatively abundant, of course there will be an imme- 

 diate subsidence, and that in the kidney, — and a renal con- 

 cretion will be the consequence. 



All preceding observations infer se\-e re disease of the kidneys 

 in this diathesis. The present history fully confirms this infe- 

 rence. The frequent attacks of nephritis, the pains in the 

 Teno-lumbar regions, the coagulable fibrine, the albuminous 

 and other morbid qualities of the urine, fully attest this con- 

 clusion, and indeed scarcely leave a doubt of its correctness. 



Whether disease of the bladder be an essential consequence, 

 the facts at present known are not sufficient to decide. In the 

 present case, I think, there can be little doubt of its being 

 affected in some degree; and as most of those cases, with the 

 histories of which we are best acquainted, appear to have termi- 

 nated rather suddenly — a very frequent occurrence in diseases 

 of the bladder and kidneys, this may be considered as 

 strengthening the presumption of the bladder being more or 

 less diseased, or, at all events, liable to become so. 



With respect to the medical treatment adapted to such cases 

 we scarcely know any thing from experience. This arises from 

 the limited field of inquiry necessarily presented, from the 

 rarity of the affection, to those competent to the task. With 

 but one or two exceptions, the opportunities of acquiring prac- 

 tical information occurred to those who probably had not 

 devoted, and consequently had not qualified, themselves for 

 inquiries of this description ; and who possibly were uncon- 

 scious at the moment of the nature of the disease entrusted to 

 their care. "As to the remaining species of calculi," says 

 Dr. Marcet, *' and especially the cystic oxide, since these are 

 soluble both in acids and alkalis, the use of the one or the 

 other class of re-agents must be determined by collateral cir- 

 cumstances and by future trials*." 



Dr. Prout observes, *^ With respect to the medical treatment 

 to be adopted, this will depend on circumstances. In the first 

 * On Calculous Disorders, Ed. 2d., p. 181. 



