Observations on Mr. Branaes Paper on Calculi. 24 1 



terior lobe of the prostate gland having become enlarged (a 

 change which it frequently undergoes about that period of 

 :. life), and having formed a barrier between the calculi and 

 the orifice of the bladder, so that they no longer irritated 

 that part either in the act of making water, or in the diffe- 

 rent movements of the body, but lay in the lower posterior 

 part of the bladder without producing any disturbance. Their 

 number prevented the pressure from being great upon any- 

 one part of the intestine immediately behind the bladder, and 

 their motion on one another rendered their external surface 

 smooth, and probably prevented their rapid increase. The 

 other patient was under a course of Perry's lixivium ; and 

 when the symptoms went away, he published the case in 

 proof of the efficacy. of that medicine in dissolving the stone. 

 I examined the bladder after death, and found fourteen cal- 

 culi ; the largest of the size of a nutmeg, the others smaller. 

 There was the same enlargement of the posterior lobe of the 

 prostate gland, and the calculi were exactly under the same 

 circumstances as in the former case. 



In several cases, in which I have examined the body after 

 death, calculi have been found inclosed in cysts, formed be- 

 tween the fasciculi of the muscular coat of the bladder, so as 

 to be entirely excluded from the general cavity, and there- 

 fore had not produced any of the common symptoms of stone. 

 I have seen in the same bladder, two, three, and even four 

 such cysis, each containing a calculus of the size of a walnut, 

 It is a circumstance deserving notice, that in the case 

 which gave celebrity to Mrs. Stevens's medicine, and pro- 

 cured her a remuneration from parliament, the bladder was 

 not examined after death. 



That calculi in the bladder do sometimes increase, while 

 the- patient is using alkaline medicines, is fully proved bvthe 

 following examples, which also show that the uric acid and 

 phosphates are. formed in different proportions, according to 

 the peculiarities of the constitution. 



A gentleman who suffered from symptoms of stone was 

 sounded and a stone was found in his bladder. I put him 

 on a course of alkaline medicines, and he voided a small com- 

 pact calculus, composed of uric acid, and evidently formed 

 Vol. 32. No. 127. Dec, 1808. 0/ in 



