CUTANEOUS CONCRETIONS 



391 



salts deposited upon them. Berlioz l gives the following table 

 from the analysis of four specimens : 



Tonsillar concretions consist chiefly of carbonate and 

 phosphate of calcium deposited upon the inspissated secretions 

 and desquamated cells of the tonsillar crypts. According to 

 some authors, leptothrix threads frequently form the nucleus of 

 the concretions. 



Cutaneous concretions are occasionally observed, located 

 chiefly in the subcutaneous tissue, often occurring multiple. 

 The origin is possibly in dilated sebaceous glands with retained 

 secretions. Unna considers that calcium soaps are formed as a 

 first step, but an analysis of such material by Harlay 2 showed 

 87.2 per cent, of ash, 12.8 per cent, organic matter, 0.9 per 

 cent, of fat ; calcium phosphate constituted 65.2 per cent., and 

 calcium carbonate 16.4 per cent. Gascard 3 found in similar 

 material 23.4 per cent, organic matter, and of the inorganic 

 matter, 91.1 per cent, was calcium phosphate, and 8.9 per cent, 

 calcium carbonate. 



Gouty deposits observed in the subcutaneous tissues, as well 

 as along the tendons, articular cartilages, etc., consist usually of 

 nearly pure biurate of sodium and potassium. Ebstein and 

 Sprague 4 found the composition of such material to be as follows : 



Uric acid 59.70 



Tissue organic matter 27.88 



Sodium oxide 9.30 



Potassium oxide 2.95 



Calcium oxide 0.17 



MgO, Fe, PA, S . traces 



After a time, however, calcium salts may be deposited, and 

 Dunin 5 has observed deposits resembling gouty tophi that were 

 merely calcium salts. 



1 Jour. Pharm. et Chim., 1891 (23), 447. 



2 Jour. Pharm. et Chim., 1903 (18), 9. 

 3 /6id, 1900 (12), 262. 



4 Virchow's Arch., 1891 (125), 207. 



5 Mitt. Grenzgeb. Med. u. Chir., 1905 (14), 451. 



