121 On Gravelly and Calculous Concretions. 



minution of his profits, if he did not occasionally substitute 

 cream of tartar, or the dilute sulphuric acid : an innocent and 

 •safe practice, in his opinion. Now, so satisfied are our pa- 

 tients of the pernicious effects of acids of all kinds, that we 

 find many of them refuse to make use of our table beer 

 during the summer months, through the apprehension of 

 its acescent quality (as was before observed), and which con- 

 tinued to be the practice of Hewson, Khensk, Clapham, and 

 others, for years back : nor do our present two greatest suf- 

 iierers, Sing and Cox, venture on it at any season but with 

 the greatest caution. 



To a removal, then, from the former occasional causes 

 we may attribute no small share of the alleviation of those 

 diseases which takes place with us : a practical observation, 

 that cannot be too generally known. But to return to my 

 subject : — On the slightest appearance of gravelly symptoms, 

 unconnected with fever, or inflammatory tendency of the 

 urinary system, our patients have recourse to an alkaline 

 medicine, the gravelly piils (as they term them), which 

 consist of desiccated soda, in the most convenient form for 

 hospital practice, as well as most suited to gouty stomachs. 

 Of this (as first advised by Beddoes,) one drachm, with the 

 addition of a few grains of capsicum, or drops of essential 

 oil, and the necessary quantity of hard soap, or extract, is 

 made into twenty pills. Of these, from three to six, or 

 more, are taken in the twenty-four hours ; and are found 

 sufficient, not only to alleviate or remove these conjplaints, 

 but even to render the interference of the physician but sel- 

 dom necessary. We have had also occasion to remark, that 

 several of our patients, induced by their marked beneficial 

 effects, carried these ])ills about them, so as to have occa- 

 sional recourse to them, without much attention to either 

 dose or number. 



To this practice, then, we would be disposed to attribute 

 the very pleasing and interesting consideration, that, among 

 so many gravelly patients, there has not occurred, in the 

 course of ten years, a single operation of lithotomy ; nor 

 has the catheter, even in the hands of our expert and able 

 surgeon, Mr. Macklin, been able to discover the smallest 



occasion 



