XIV, 5 
Padua: Cystolithiasis with Dietetic Deficiency 485 
Composition of layers. 
Layer. 
Constituent. 
Chief. 
Minor. 
Cortex and second layer. 
Amorphous and triple phoB- 
Calcium carbonate and trace 
phate. 
of calcium oxalate. 
bonate, and ammonium 
urate. 
Do. 
trace of uric acid. 
CASE 9 (group II) 
E. M. (37388), 13 years old, single, female, Filipino, student; born and 
living in Santo Tomas, Batangas; admitted to hospital July 26, 1915, 
complaining of painful, frequent, diihcult, and scanty micturition, and pus 
discharge occasionally. The condition is of about six years standing. No 
history of past diseases nor of beriberi. She is moderately developed but 
poorly nourished. 
Clinical diagnosis. — Cystolithiasis, chronic cystitis, and prolapse of the 
rectum. 
Urine analysis. — Reaction, alkaline; sugar, negative; albumin, a decided 
trace. Microscopic, abundant pus cells, some blood and mucus. 
Cystolithotomy was performed August 3, 1915; the patient was dis- 
charged September 2, 1915. 
Calculus analysis (one white irregular stone). 
Grams. 
Whole calculus 
31.5 
Portion analyzed 
15.1 
Cortex, analyzed portion 
5.5 
Second layer 
5.2 
Third layer 
4.0 
Nucleus 
0.4 
Weight by calculation. 
Grams. 
Whole cortex 
11.5 
Whole second layer 
10.9 
Whole third layer 
8.3 
Whole nucleus 
0.8 
Composition of layers. 
Layer. 
Constituent. 
Chief. 
Minor. 
Triple and amorphous phos- 
phate. 
Amorphous phosphate and uric 
acid. 
Calcium carbonate and am- 
monium urate. 
Ammonium urate and cystine. 
Amorphous and triple phos- 
phate. 
Uric acid, ammonium urate, 
and calcium sulphate. 
Second layer (brownish 
white) . 
Triple and amorphous phos- 
phate. 
