STONY CONCRETIONS IN THE PELVIS OF THE KIDNEY. 63 



had sharp outlines and distinct nuclei, which rendered it probable 

 that they had been detached by some mechanical force. 



The passage of a calculus through the ureter is sometimes at- 

 tended by symptoms to which the term renal colic has been applied. 

 Clots of blood and parasites passing through the ureter may like- 

 wise give rise to renal colic ; and it is not impossible, though very 

 improbable, that a mere spasm of the ureter may sometimes have 

 like effect, but such cases are comparatively rare. It is incompre- 

 hensible why large stones often pass unnoticed through the ureter, 

 while much smaller ones (which are not always rough or angular) 

 may cause intense anguish. In this aif ection, the patient (often 

 after a severe jolting) suddenly feels a frightful pain darting from 

 the kidney toward the bladder, and thence to the thigh and testicle. 

 He screams and writhes with agony, and grows cold, prostrate, and 

 demoralized. Though constantly striving to micturate, but little 

 water flows. Vomiting is frequent, so that the seizure is apt to be 

 mistaken for biliary colic or eriteralgia. In irritable subjects there 

 may be convulsions. Sometimes temporary remission interrupts the 

 torment of the patient soon, however, to be followed by renewed 

 and violent exacerbations. In other cases the pain increases -stead- 

 ily, and then ceases as suddenly as it commenced ; and, unless the 

 calculus give rise to fresh trouble by its presence in the bladder, a 

 complete recovery ensues immediately. Such attacks may pass off 

 in a few hours, and rarely last over twenty-four hours ; and, in spite 

 of the formidable aspect of its symptoms, life is hardly ever en- 

 dangered by renal colic. Sometimes, though not often, the im- 

 provement is incomplete ; the pain diminishes, but does not cease 1 

 entirely, the symptoms of colic becoming complicated with those 

 of pyelitis. 



TREATMENT. The treatment of uric-acid and calcareous infarc- 

 tions is, of course, out of the question. In discussing the treat- 

 ment of vesical calculus, we shall speak of the procedures theoreti- 

 cally proposed for the purpose of dissolving stones, and shall then 

 point out their inefficiency. 



In treating renal colic, it is merely necessary that the physician 

 be sure of his diagnosis, in order to obtain the happiest results. 

 He must not content himself by applying leeches, giving restora- 

 tives for the small pulse and cool skin, or with other useless half- 

 measures, but should boldly order opium every hour or two. The 

 anaesthetic action of the opium alone is insufficient to account for 

 the relief which usually follows this treatment. It is much more 

 likely that the muscular fibres of the ureter, which have been 

 thrown into a state of contraction by the irritation of the stone, 



