STONY CONCRETIONS IN THE PELVIS OF THE KIDNEY. 59 



the kidney) in an open vessel till it undergoes alkaline fermentation, 

 the sediment will become tough and mucous. We can only be sure 

 of disease of the pelvis of the kidney, when we find connected 

 groups of spindle-shaped flat epithelium in the urine, especially 

 after violent exercise. But, even in cases where the patient com- 

 plains of pain in the region of the kidneys, extending thence to the 

 pelvis and testicles, we must not be misled, by any existing dysuria, 

 into the diagnosis of pyelitis. 



TREATMENT. For acute catarrhal pyelitis we may refer to what 

 has been said already concerning acute interstitial nephritis. At the 

 outset, the application of leeches, cut cups, as well as of cold, over the 

 region of the kidney, is advisable ; and, when the pain and strangury 

 are very severe, the exhibition of opium and the subcutaneous injection 

 of a solution of morphine. In order to dilute the urine as much as 

 possible, the patient should drink freely of liquids, avoiding the use of 

 salted or spiced food or beverage. The employment of alkalines, and 

 the alkaline-saline mineral waters of Vichy and Karlsbad is deserv- 

 edly in repute in the treatment of pyelitis. If the malady assume a 

 tedious form, let the patient use long-continued warm baths, and apply 

 hot poultices to the lumbar region. The acratothermae are coming 

 more and more into use in the treatment of pyelitis and its kindred 

 complaints. At the baths and springs of Wildbad, I have seen the 

 utmost benefit result from making the patient spend as long a time in 

 the bath as possible, and causing him to drink as much of the pure 

 lukewarm water of the springs as he could take without inconvenience. 

 We do not attempt to decide whether camphor, which enjoys so high 

 a reputation as a remedy for all irritations of the urinary passages, 

 really exerts the beneficial action ascribed to it. Where there is 

 tedious suppuration, astringents should be employed, especially tannin, 

 for reasons already given. In order to diminish the production of pus, 

 we may also try whether the patient will bear the exhibition of the 

 balsams, especially copaiba. For this purpose, Oppolzer recommends 

 the patient to drink lime-water and milk (aquae calcis, milk, aa Ib. to 

 Ib. ij. daily). 



CHAPTER III. 



STONY CONCRETIONS IN THE PELVIS OF THE KIDNEY. 



[ETIOLOGY AND PATHOLOGY. Stony concretions may form in 

 any part of the urinary passages, from the uriniferous tubules to the 

 bladder. They may assume the shape of a fine powder (sand or 



