86 



PRODUCTS, ADVENTITIOUS. 



bile-pigment 10.81. Bertazzi* maintains cop- 

 per to be a constant ingredient of biliary calculi, 

 having found it in every one of fourteen speci- 

 mens, apparently to an amount varying directly 

 as the quantity of colouring matter present. 

 Heller f confirms the statement of this chemist. 

 Bertazzi failed in detecting copper in the bile 

 collected from the gall-bladders often persons. 

 In very rare instances calculi have been found 

 composed of inspissated bile. 



Mr. Taylor J discovered a calculus in the 

 collection of the College of Surgeons, pre- 

 sumed to be biliary, and composed of the stea- 

 rate of lime. It floated in water, and had a 

 lamellar structure ; the lamella? being easily 

 separable and alternately of white and reddish 

 yellow colour. In the centre was a small 

 cavity. The analysis, justifying the above 

 view of its composition, is given in full. This 

 rare description of calculus appears to signify 

 a stage of transition from the common cases to 

 those instances in which the biliary passages 

 contain masses composed essentially of car- 

 bonate and phosphate of lime, especially of 

 the former salt. Richter describes a case in 

 which the liver contained a multitude of such 

 bodies varying in size from a pea to a cherry. 

 Matter of this kind is occasionally found coat- 

 ing the gall-bladder and ducts ; and in the 

 interior of cysts in the substance of the organ. 

 (Baillie and Zannini.) 



(1.) Pancreatic. Calculi of the pancreatic 

 duct have been observed in rare instances by 

 Matani, Eller, Biumi, Galeati, and others. 

 Baillie found some as large as a hazel-nut, of 

 white colour and irregular surface, which Wol- 

 laston showed were composed of carbonate 

 of lime. 



Fig. 88. represents a portion of a dilated 

 pancreatic duct, which contained an enormous 

 number of small calculi (such as are seen 

 within it in the sketch) of dull white colour, 

 perfectly round, varying in size from that of a 

 pin's head to that of a small pea, elastic and 

 hard, 



Fig. 88, 



Pancreatic calculi, natural size. ( Univ. Coll. Mus 



Pancreatic calculi have not, as far as we are 

 aware, been found in the intestine in transitu 

 outwards. 



(in.) Seminal. Calculous masses have oc- 

 casionally been detected in the vesiculae se- 

 mmales and ejaculatory ducts. || Collard de 

 Martigny found some composed of mucus and 

 coagulated albumen chiefly, with a small quan- 



* Polli, Annali di Chemica ; Milano, Juglio, 1845 

 f Archiv. vol. ii. p. 228. 

 j Lond. and Edinb. Phil. Mag. 1840. 

 Pemberton, Diss. of the Abdom. Viscera, p. 68. 

 |j Hartmann, De calc. in vesic. seminal. Erfurt, 

 1765. 



tity of calcareous salts.* These calculi some- 

 times accumulate in vast numbers ; thus two 

 hundred were discovered in the right vesicula 

 seminalis of a man aged forty-five -f ; no symp- 

 tom had occurred during life connected with 

 the organ. 



(?z.) Mammary. The lactiferous ducts 

 are occasionally the seat of minute calctilous 

 bodies ; Gooch, Haller, Reil, and others report 

 cases of the kind. Morgagni alludes to their 

 existence in the breast of a gouty person. The 

 history of the case generally connects their 

 production with the function of suckling, and 

 sometimes with obstruction of the flow of 

 milk. 



(o.) Vaginal and pudendal. Calcareous ac- 

 cumulations in these parts are not extremely 

 rare. They originate in a deposition of phos- 

 phates around some foreign body; a pessary for 

 example, or around a nucleus of thickened 

 mucus accumulating either from habits of un- 

 cleanliness or from malposition of the uterus. 

 Kohler discovered five large chalky-looking 

 masses, weighing together more than seven 

 ounces, in the vagina of a woman, aged forty, 

 affected with prolapsus uteri. 



(p.} Uterine. The internal surface of the 

 uterus is in rare instances found more or less 

 extensively lined with, or studded with rounded 

 masses of, saline matter of variable consistence. 

 This condition has been observed in cases of 

 deviation of axis of the uterus ; the saline 

 matter is in all probability composed mainly of 

 phosphate and carbonate of lime. 



(B.) CONCRETIONS or PSEUDO-CALCULI. 

 Concretions are masses composed of saline 

 materials deposited in a pre-existing organic 

 basis, the former, as they increase, gradually 

 encroach on and, as it were, dispossess the lat- 

 ter, until eventually, in many instances, all ob- 

 vious traces of its existence have disappeared. 

 The saline matters are commonly deposited 

 punctatim ; and the organic basis,, in which 

 they accumulate may be non-stromal (as, for 

 example, tuberculous matter, atheromatous 

 matter, &c.), or stromal (as, for example, 

 fibrous tumour, &c.) And, again, the natural 

 j textures (as, for instance, cellular tissue, 

 tendon, &c. in the case of tophaceous con- 

 cretions) ; the solid elements of the cir- 

 culating fluid (as the fibrin of the blood in 

 the case of phleboliths) ; and, lastly, various 

 adventitious substances (as those mentioned 

 ) above), may severally act the part of that 

 organic basis. 



(.) Elementary cell. Perhaps the sim- 

 plest form of true concretion is that in which 

 an epithelium-cell becomes coated or studded 

 with saline material. We have seen this con- 

 dition in the epithelium lining adventitious 

 cysts, in the epithelium floating in pleuritic 

 effusions, and occasionally in that discharged 

 with the urine. The concretions, not very un- 

 commonly found in the choroid plexus, con- 

 sist of round cells coated with calcareous salts. 

 Flakes of albuminous substance may some- 



* Journ. de Chim. Med. t. iii. p. IS*- 

 f Archives de Medecine, Juin, 183 



