£40 Observations on Mr. Brande's Taper on Calculi. 



only know from experience, that, to whatever extent the 

 medicines are given, no such effect takes place. The cir* 

 cumstance of the exterior lamince of calculi extracted from 

 patients, who had persevered in a course of alkaline prepa- 

 rations, having been found softer than the parts towards the 

 centre, has always been considered &.* a proof of the action 

 of the medicines upon the calculus, and led to the belief, that 

 where the stone was small, it might be wholly dissolved. 

 This, however, Mr. W. Brande has now proved to be a de- 

 ception, and that the soft part is not a portion of the origi- 

 nal calculus, but a newly formed substance, in which the 

 uric acid is not deposited in crystals, but mechanically mixed 

 with the phosphates, and the animal mucus in the urine. 



Having met with cases, which confirm Mr. W. Brande's 

 observations, it will be satisfactory to state them, as they may 

 assist in doing away many erroneous notions generally en- 

 tertained on this subject. 



The opinion, that calculi in the human bladder have been 

 entirely dissolved, has received its principal support from 

 instances having occurred, and those by no means few in 

 number, where the symptoms went entirely away while the 

 patients were using alkaline medicines, and never afterwards 

 returned. This evidence appears to be very strong, but it 

 will be found from the following cases that it is not so in 

 reality. Since the fallacy has been detected in all the in- 

 stances in which an opportunity was afforded of examining 

 the bladder after death. Two of these 1 shall particularly no- 

 tice, because they were published during the patient's life- 

 time in proof of the stone having been dissolved. 



Both patients were great sufferers from the symptoms of 

 stone for many years; but when they arrived at the ase of 

 sixty-eight, or thereabout, the symptoms entirely left them. 

 The one had been taking the saline draught in a state of 

 effervescence, under the direction of the late Dr. Huhne : 

 the cure was attributed to this medicine, and the case was 

 published in proof of its efficacy. When the patient died I 

 examined the bladder, and found twenty calculi ; the largest 

 of the size of a hazel-nut, the others smaller. It appeared 

 that the going off of the symptoms had arisen from*. the pos* 



tetior 



