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On Graveliy and Calculous Con-cretions. 209 



kideed, when we consider that the operation is seldom, if 

 ever, attempted in the country. And why this should 

 happen here, we shall be presently, perhaps, better able to 

 judge. 



The reverse of this occurs in the sister kingdom ; and 

 the Irish student feels astonished at the frequency of the 

 operation in all the London hospitals, though also per- 

 formed in those of the more considerable country towns ; 

 and, upon inquiry, he finds that a large proportion of these 

 patients come up from the cider counties of Hereford, 

 Devon, &c.: and it must naturally occur to him, that the 

 general use of fermented liquors of every kind, beer, cider, 

 perry, and factitious wines, which prevail in England, ren- 

 ders the disease of more frequent occurrence there than with 

 us, the great mass of our people being deprived of these 

 luxuries. 



If we pass over to the Continent, we find our neighbour- 

 ing provinces, Picardy, Normandy, and Britany, in par- 

 ticular, still more subject to affections of this kind ; so 

 much so, that the late Mr. Dease could not give credit to 

 the extraordinary number of patients operated on, in one 

 year only, in the hospital of Rouen ; though many must 

 have, of course, repaired to Paris. The sanje, though in a 

 lesser degree, takes place in Champagne ; and it is almost 

 imnecessary to observe, that the general beverage of the 

 northern provinces consists of cider, or of poor v.ine, 

 e(]ually acescent in its nature, and prone to the acetous 

 fermentation. The Champagne, though somewhat less so, 

 is replete with carbonic acid "gas and disengaged tartarous 

 acid ; and though, in the more southern provinces, this 

 malady cannot be considered as endemial, yet it is of fre- 

 quent occurrence in the hospitals of Montpellier. 



For, even in these favoured climes, where wine is of so 

 little value, and withal so spirituous, the unfortunate pea- 

 sant is obliged to content himself with an inferior quality, 

 prepared by a second maceration of the marc of the grape, 

 which he denominates plcquet ; a patois appellation, most 

 happilv applied to its highly acid quality. 



In that once happy country, Switzerland, on the con- 

 trary, as baron Mailer assures us, the disease is by no 

 means frequent, and chiefly confined to the children of the 

 poorer sort ; their mountainous and elevated situations af- 

 fording them little or no vinous liquors ; whereas their 

 neighbours, the inhabitants of the Rhine and Moselle, as 

 well as some tracts on the banks of the Danube, arc pecu- 

 liarly aflHictcd. 



The truth of this observation we find confirmed by the 

 Vol. 23. No. 91. Dec. 1603. O medical 



