TENDENCY TO CALCULOUS DISEASES. 65 



as favouring the occurrence of calculous diseases ; but a much coarser, and 

 worse fermented material, in rye, barley, oats, and various mixtures of peas, 

 with wheat or barley, has been, and perhaps still continues, to a certain degree, 

 in use in Scotland, and the North of England, without being prodiictive of such 

 an effect. There are doubtless, however, various collateral circumstances that 

 have not been sufficiently ascertained, which may have the power of modifying 

 the effects of any particular description of food ; and it is even very probable, 

 that the laxative tendency of some of the coarser kinds of farinaceous aliment, 

 may have a salutary influence, and obviate the disadvantages which might 

 otherwise arise from their employment. 



The cyder counties were at one time supposed to be peculiarly liable to 

 calculous complaints ; but so little ground is there for this opinion, that Here- 

 fordshire seems to have a very peculiar exemption from that malady; and 

 Devonshire, not to have more than the average cases of other counties. 



From the documents to which I have referred, it appears, that the tendency 

 to produce calculus, is much greater in Norwich, and London, than in their re- 

 spective country districts*. The same circumstance is very strikingly exem- 

 plified in Bristol ; for according to Mr. Smith's paper, to which I have had 

 occasion so frequently to refer, 354 calculous cases have occurred in 82 years, 

 at the Bristol Hospital, which is at the rate of 4.3 per annum. But of these, 

 173, or very nearly one half, were derived from Bristol and its liberties, which 

 comprise a population of 87,000 persons ; and 181 only, from the neighbouring 

 districts, containing not less than 750,000 inhabitants-|-. The annual propor- 

 tion would therefore be not less than 2.1 per annum for Bristol, which is 

 1 for 41,000 inhabitants ; while in its extensive and populous country district, 



* I have mentioned the calculous tendency of Norwich, as being nearly double that of the county 

 at large. Four of the eastern hundreds, however, viz. Taverham, Walsham, Tunstead, and Happing, 

 rather exceed Norwich in this disposition ; having, in a joint population of 26,000, produced 75 cases 

 of calculus, or 1.34 per annum. Those hundreds join each other ; and one of them, Taverham, 

 abuts on the Norwich district. 



f Bristol, owing to its central position, receives patients from the counties of Somerset, Gloucester, 

 Wilts, and Monmouth, as well as from South Wales ; and I go upon the supposition (which I believe 

 to be not far from the truth) that these districts transmit patients to the Bristol Hospital, in nearly 

 an equal degree, with one or other of the hospitals of Bath, Exeter, Salisbury, Gloucester, or Hereford, 

 according to local convenience. 



MDCCCXXIX. K 



