]'\/:t MOxohOMOSis 465 



Tonsillar concretions consist chiefly of carbonate and phosphate 

 of calcium deposited upon tlie inspissated secretions and desciuaniated 

 cells of the tonsillar crypts.^"' According to some authors, leptothrix 

 threads frequently form the nucleus of the concretions. 



Cutaneous concretions are occasionally observed, located chiefly 

 in tlie suhcutaiieous tissue, often occurring multiple. The origin is 

 possibly in dihited sebaceous glands with retained secretions. Unna 

 considers that calcium soaps are formed as a first step, but an analy- 

 sis of such material by Harley ^^ showed 87.2 per cent, of ash, 12.8 

 per cent, organic matter, 0.9 per cent, of fat; calcium phosphate con- 

 stituted 65.2 per cent., and calcium carbonate 16.4 per cent. Gas- 

 card ^' found in similar material 23.4 per cent, organic matter, and 

 of the inorganic matter, 91.1 per cent, was calcium phosphate, and 

 8.9 per cent, calcium carbonate. 



Gouty deposits observed in the subcutaneous tissues, as well as 

 along the tendons, articular cartilages, etc., consist usually of nearly 

 pure biurate of sodium and potassium. Ebstein and Sprague ^* found 

 the composition of such material to be as follows : 



Uric acid 59.70 



Tissue organic matter 27.88 



Sodium oxide n.30 



Potassium oxide 2.95 



Calcium oxide 0.17 



MgO, Fe, P2O,, S traces 



After a time, however, calcium salts may be deposited, and Dunin ^^ 

 has observed deposits resembling gouty tophi that were merely cal- 

 cium salts. 



PNEUMONOKONIOSIS 



In a number of cases of the different forms of this condition quan- 

 titative analyses have been made, which may be briefly discussed as 

 follows : Not only does the lung of every adult contain considerable 

 amounts of coal-pigment stored up in the connective tissues (and also 

 in the peribronchial glands), but also, which is perhaps less generally 

 appreciated, considerable quantities of silicates are also present (chal- 

 icosis) from inhaled dust. AVoskressensky -'^ found silicates in all of 

 54 lungs examined, except two from infants. The lungs of individ- 

 uals whose occupations do not expose them especially to dust inhala- 

 tion contain increasing amounts of silicates in direct proportion to 

 age ; the silicates constitute then from 3.5 to 10 per cent, of the total 

 ash of the lungs. There is always a larger proportion of silicates 



i5:McCarthy, Brit. Med. Jour.. Oct. 28. 1911. 

 16 Jour. Pharm. et Chim., 1903 (18), 9. 

 IT Ihid.. 1900 (12). 262. 

 isVirchow's Arch., 1891 {\2r^), 207. 



i9:Mitt. Grenzpeb. Med. u. Chir., 190.", (14). 4r>l : also Kahn. .\rch. Int. Med., 

 1913 (11). 92. and M. B. Schmidt, Deut. med. Woch., 1913 (39), 59. 

 20 Cent. f. Path.. 1S98 (9), 296. 

 30 



