Frof. E. D. Smith on Calculous .Affections. 307 



ced in them by the long contmued use of particular sub- 

 stances. Thus, although a tendency to form uric calculi 

 indicates the propriety of using alkaline remedies, it is cer- 

 tainly of consequence what peculiar alkalies are employed 

 and a judicious selection can proceed only from an acquaint- 

 ance with the specific and distinguishing properties of each. 

 May it not be apprehended that a want of due attention to this 

 subject has retarded the progress of medical science, and 

 ought not any opinion in favour of such neglect, to be com- 

 batted as a dangerous error? 



3. From the knowledge of the composition of urine and 

 of urinary calculi, should not ev^en the really scientific phy- 

 sician proceed with caution in the use of his remedies? 

 This query is connected with the fact, that not only do dif- 

 ferent calculous aiFections require distinct and totally oppo- 

 site remedies, but also on another circumstance. A reme- 

 dy, which is demanded in a certain state of things, may, 

 by its too long continuance, not only counteract the evil, 

 which it was intended to do, but it may produce an oppo- 

 site and equally injurious state. In such a case the chem- 

 ical knowledge of the prescriber could alone direct the 

 course, that should be pursued. From the analyses of 

 healthy urine it appears to be granted that when it is first 

 voided, an acid character predominates, and it is believed 

 that a certain degree of this predominance is necessary, for 

 the purpose of holding in solution the various neutral salts, 

 with which the urine is charged ; now, if this be the fact, it 

 is easy to conceive that an increased quantity of this acid 

 will occasion disease of one kind, and a diminished propor- 

 tion that of another. 



If therefore, in the attempt to remove the former state, 

 the remedies employed, be pushed too far, there can be no 

 doubt that the latter would be induced. 



To possess then the knowledge, that would be requisite 

 for maintaining in equilibrium these easily alternating con- 

 ditions of the system, as also to select the preferable reme- 

 dy for any determinate class, must be highly advantageous, 

 if not indispensable. Numerous experiments, connected 

 with this subject, have induced Mr. Brande (London Medi- 

 cal and Physical Journal, Vol. 30) to draw the following 

 therapeutical conclusions. 



