XIV, 6 Padua: Cystolithiasis with Dietetic Deficiency 483 
adies. Diseases of the genito-urinary tract have been included 
in the case records to aid in explaining the formation of calculi. 
Whenever autopsy was performed on any of the cases, attempt 
was made to note the anatomical diagnosis for possible evidences 
of beriberi. Urine examinations have been made in most of the 
patients. 
After weighing the stones, they were cut with a fine saw into 
two approximately equal parts, one of which was utilized in the 
analysis, while the other remained in the museum for further 
reference or subsequent study. Those that were cut were again 
divided into two, thus making the analyzed portion about one- 
fourth of the original stone. The layers of the portion analyzed 
were peeled off and weighed individually. Having determined 
by proportion the weight of the individual layers in toto, based 
on the weight of the whole or of half of the stone and that of 
the analyzed portion of the layer, the latter was subjected to 
a qualitative chemical analysis according to Heller’s scheme. 
Experience showed that the chemical phenomena were some- 
times so misleading that the .interpretation of results did not in 
some instances approach the desired accuracy. To check this 
error, I adopted the following modification in the analysis of 
each layer: The layer was ground to a powder and a small 
amount of the powder was dissolved by the aid of gentle heat in 
dilute hydrochloric acid; after filtering the solution, two drops 
of the filtrate were put on a slide and subjected to the action of 
ammonia vapor beneath a shallow glass container; about fifteen 
or twenty minutes were allowed for the reaction, and the crystals 
or sediments formed were examined and identified under the 
microscope. 
In case of multiple calculi, the largest was weighed and ana- 
lyzed in the same manner. The smaller ones were also cut and 
analyzed, but not recorded. The weight of the largest stone and 
that of the individual layers were calculated, as it was intended 
to determine or compute as far as practicable the rate of growth. 
As a whole, the patients on admission were in a state of rela- 
tively low vitality, which is shown by the prolonged recovery 
after operation in the majority of the cases, sometimes three 
months as in case 25. Eleven of the cases gave a positive history 
or signs (or both) of beriberi. Eighteen were undernourished 
individuals with an unreliable history of beriberi, all of which 
belong to the first group of my clinical cases where the data were 
taken with very little or no stress on the nutritional bearing of 
the disease. Twenty-three of the series were determined as 
