3020 Prof. E. D. Smith on Calculous Affections. 
a change in the qualities and appearance of the urine gen- 
erally indicates the approaching mischief and affords the 
opportunity of arresting its progress. When the uric aci 
is In excess, it occasions irritation in the urinary passages 
and finally, a discharge of very small crystals, like red sand: 
and when the alkaline salts predominate, a fine white and 
sandy substance is voided.* ei 
A previous knowledge of the subjett and a proper atte 
tion to these indications will generally enable us to apply 
correct remedies and thus to destroy in the germ what 
would be irremediable‘at maturity. arate 
Without stopping to investigate the fact, whether there 
may be a short and direct communication from the stomach 
to the bladder, or whether this communication may depend 
upon the retrograde action of the absorbents, it will be suf- 
alkalies for the relief of gravelly complaints. This seems 
to have been the practice of the ancient Greek physicians; 
as stated in the second volume of Johnson’s Animal Chem- 
istry,.and it is well known to have been that of the mod- 
erns, from the era of Mr. Steven’s celebrated lithontrip- 
tic down to the present time. _A little reflection will satisfy 
‘at this mode of practice has been too empirical ; for if 
chemical analyses have demonstrated that calculous concre- 
tions are sometimes of opposite natures, it must be allowed 
that the same remedy cannot be adapted to every kind. — It 
is then surely incumbent upon the physician to ascertain the 
real nature of the case; and, from the want of knowledge 
to do so, there can be no doubt that such diseases, instead 
of being relieved, have often been aggravated. To this 
difference in the constitution of calculous matter it is owing 
that both the strong and the weak acids have sometimes 
used with eminent benefit; and yet the indiscriminate 
cription ofacids would frequently produce the most ser 
me a re, < ce he Ps 2 
* London Medical and Physical Journal, Vol. 30, page 327, &. 
