124 



incapable of receiving more, this saline substance would ossify all the tis- 

 sues, as it sometimes does that of the arteries, the ligaments, the carti- 

 lages and membranes, if the urine did not carry off the greater part. 



In the rickets, it is by the urine that the phosphate, of lime is carried 

 out of the system, and the absence of that substance is the cause of molli- 

 ties ossium $ on the approach of fits of the gout, the phosphoric ingredi- 

 ents of the urine diminish, and seem to be carried to the joints, to pro- 

 duce in their vicinity arthritic concretions. 



The great quantity of saline and crystallizable elements which enter 

 into human urine, accounts for the frequency of the concretions which 

 form in that fluid. Urinary calculi were long considered as formed of a 

 single substance, which the ancients thought analogous to the earth of 

 the bones, and which Schf^ 1 ^ *<^K for uric acid. The late investigations 

 of M. M- Fowi uroy and Vanquelin have shown, that the component parts 

 of urine are too numerous and too complex to produce uniformly calculi 

 of one kind : that urinary concretions, most frequently formed from uric 

 acid, contain urate of ammonia, phosphate of lime, phosphate of ammo- 

 nia and magnesia, oxalate of lime, silex, and that these substances, singly, 

 or in binary and ternary combinations, form the materials of nearly six 

 hundred calculi which they analysed. Notwithstanding the extent of 

 these researches, there is reason to believe, that when carried further by 

 the same chemists, they will be attended with results still more varied. 

 For, as there is no integral molecule in the body which may not be voided 

 with the urine, and be found in the urine, so it is conceivable, that under 

 certain circumstances, which it is impossible to assign or to forsee, every 

 tjilng in the human body that is capable of concretion, might supply the 

 materials of urinary concretions. 



This variety of elements in the composition of urinary calculi, the ab- 

 sence of signs, by which to ascertain their nature, the sensibility of the 

 parietes of the bladder which would be irritated by agents capable of dis- 

 solving the concretions( so frequently formed in its cavity, must render it 

 very difficult, not to say impossible, to discover a lithontriptic which 

 should supersede the necessity of a surgical operation, whose difficulties 

 and danger have been much over-rated. 



XXXIX. The energy of the urinary system in the inhabitants of tem- 

 perate climates, has been considered as the cause of the frequency of cal- 

 culous affections in Holland, England, and France, while they are very 

 rare in more southern countries, in which the cutaneous perspiration 

 seems to be substituted, in great measure, fyr the urinary secretion. 

 There is no part of the world in which cases of stone in the bladder are 

 more frequent than in England, and especially i Holland, in which a cold 

 und damp atmosphere is unfavourable to perspiration, which is, at any 

 rate, but scanty in persons of a leucophlegmatic temperament like that of 

 the Dutch. In no other country, could a lithotnist (Raw) have operated 

 on more than fifteen hundred patients, it is said, successfully. Diabetes, 

 or an immoderate discharge of urine, a disease ivhich appears to depend 

 on an excessive relaxation of the renal tissue, js of frequent occurrence 

 only in cold and damp countries, as Holland, England, and Scotland; it is 

 more rare in France and Germany, and is unknown in warm climates. 

 This relaxation of the renal tissue in diabetes, depends on the exhaustion 

 of the urinary organs called into too frequent action, as is proved by the 

 efficacy of tonics and astringents in the treatment of that complaint. 



Cutaneous affections, on the contrary, seem to belong to the inhabitants 



