Dr. Venables on the Cystic Oxide, &c. 35 



Serum in small proportion was an occasional, but not constant, 

 ingredient. 



The treatment consisted in the exhibition of the muriatic 

 acid, and sulphate of morphia, with ipecacuanha, acetic extract 

 of colchicum, and extract of hyoscyamus, in small doses, in 

 the form of pills. The state of the bowels was also carefully 

 watched, and any tendency to constipation was obviated by 

 means of castor oil, or some other mild aperient. This plan 

 was persevered in for a considerable time, Mr. Cremer having 

 kindly undertaken to supply her with whatever medicines 1 

 might consider necessary for her relief. This plan was at- 

 tended with considerable benefit, and I believe she has not ex- 

 perienced a severe attack of renal inflammation since that period. 



On several subsequent occasions, and during the period of 

 her taking the medicine, I have had opportunities of examining 

 the urine. It would be useless to enumerate the individual 

 results, as it would only lead to a repetition of what has been 

 already stated. The only thing necessary to observe, is, that 

 the specific gravity varied, being sometimes higher, sometimes 

 lower, but never exceeding 1.025, nor falling below 1.020; 

 There was less of the cystic oxide in mechanical suspension, 

 and relatively more in solution, although the absolute quantity 

 of this principle was diminished. The urine indicated more 

 strongly an acidulous re-agency, and the quantity of lithic acid 

 was sensibly, though not materially, increased ; but what is of 

 paramount importance, the patient's sufferings were very much 

 alleviated. 



OBSERVATIONS. 



On reviewing the foregoing facts, several circumstances 

 deserving of particular notice present themselves for considie- 

 ration. We first observe a deficiency amounting almost to a 

 total absence of two natural principles — urea and lithic acid — 

 existing in comparatively great abundance in healthy urine. 

 Hence we can readily admit the exclusive tendency of this 

 diathesis, and easily explain the great purity of cystic calculi, 

 as remarked by WollaSton *, Prout, Marcet, and others, who 



* The first specimen discovered by Dr. Wollaston had a loose coating of the 

 phosphate of lime. This might have been produced by an immoderate indulgence 

 m alkaline remedies, or been furnished accidentally from the prostrate gland. 

 That it was artificially, rather than naturally produced, may be inferred from 

 the fact of the same, patieni— a boy about five years old— having died after the 

 fonnatiou of another stone, which consisted almost wholly of lithic acid. 



D 2 



