65 DR. YELLOLY'S REMARKS ON THE 



the proportion would not be more than 2.2 per annum, or 1 only, for every 

 340,000 inhabitants. ■ o v('ji-i' ri m J :rn 



,,.ln some parts of the country districts 6f Bristol, there are very singular 

 anomalies ; for tlie town of Chippenham, with only 3200 inhabitants, is stated 

 by Mr. Smith, to have furnished as many cases of lithotomy, as the whole re- 

 maining county of Wilts. On the calculation of 18 cases in 82 years, or 1 in 

 4.5, which is about half the amount furnished by Wilts, there woiild, in this 

 little town, be a tendency to calculous complaints, exceeding by about a fourth, 

 thai of Norwich itself. sra 



Scotland is generally regarded as but little liable to the production of cal- 

 culous diseases ; and • if Mr. Smith's calculation, of the occurrence of 8 cases 

 only per annum, in that part of the island, is a correct one, it would, on its 

 population of two millions, be in the ratio of 1 case for every 250,000 inhabi- 

 tants. But the town of Dmidee, in the county of Forfar, with a population of 

 30,000, has afforded to Mr. Crichton, of that place, in 36 years, 3 1 cases of 

 stone, out of above 70 on which he operated during that period*. This is at 

 the rate of .86 per annum, or 1 for every 35,000 inhabitants, if they had ex- 

 tended to that number. But if 5 are deducted, as having, from their designa- 

 tion in Mr. Crichton's list, the appearance of belonging to a higher class of 

 society than enters into the calculations of this paper, we should then have .72 

 per annum, or 1 case for every 41,000 inhabitants, which is about the avei'age 

 proportion of Bristol. .,-,>•. a i: ■. ri. 



In the instances which I have mentioned, it would therefore appear, that 

 the tendency to produce calculous complaints, is greater in towns than in the 

 country ; and if this should prove to be the case generally, it would seem to 

 indicate the existence, in children more particularly, of a connection between 

 some diathesis which prevails in towns, (probably the scrophulous,) and the 

 tendency to the secretion or deposition of lithic acid, on which the origin of 

 urinary calculi so much depends. I have not had it in my power to ascertain, 

 whether the greater disposition of towns to calculous complaints, applies more 

 extensively than I have mentioned. I think it probable, however; but in 

 some cases, in which I had expected to be able to connect the reports of the 

 numbers operated upon, in a particular town or district, with a certain known 



• Observations on the Operation of Lithotomy. Edin. Med. and Surg. Journal, vol. xxix. p. 225. 



