490 
Philippine Journal of Science 
1919 
The totals for one hundred eighty-nine layers show one hun- 
dred four layers or 55.03 per cent with phosphates as the chief 
constituents, and fifty-four layers or 28.57 per cent of chiefly 
uratic composition. Oxalates occurred as chief constituents in 
nineteen or 10.05 per cent of the layers, carbonates in seven or 
3.7 per cent, and there were five layers or 2.65 per cent with 
mixed phosphate and urate, phosphate and oxalate, and phos- 
phate and carbonate as the chief constituents. Table II shows 
the chief constituents of the primary stones. 
The percentage of primary phosphatic calculi is greatest in 
the individuals belonging to Groups I and II, in whom the nu- 
tritional condition was below par. In Group III, where the 
percentage of urates predominates, the affected individuals belong 
to a class with adequate food supply. 
These findings are not in accord with the findings of foreign 
investigators. Wells (25) and others say that urate calculi ex- 
ceed the rest in frequency. Ultzmann(24) found that out of five 
hundred forty-five cases of primary calculi 80.9 per cent were 
with nuclei consisting of uric acid (and urates), 5.6 per cent 
of calcium oxalate, 8.6 per cent of earthy phosphate, 1.4 per cent 
of cystin, and 3.3 per cent of some foreign body. Gordon’s (13) 
statistics on his investigation of one hundred calculi which give 
a predominance of uratic stone in England may here again be 
recalled. Reed (20) reports a case in which the calculus was 
composed of urate and concentric rings of calcium oxalate with 
a colloid nucleus. Kahn and Rosenbloom(i5) have analyzed a 
number of urinary calculi and in their conclusion they state: 
1. The large majority of renal stones are composed of oxalate of lime. 
2. Uric acid and the urates are found in all renal concretions, but 
it is rare to find a renal calculus that is mainly composed of 
the urates. 
These same authors present analyses of two vesical calculi 
and both were made up almost exclusively of uric acid. Lastly 
Spiegel, (23) in an analysis of a large number of urinary stones, 
both renal and vesical, finds that only twenty of fifty stone 
formations contain phosphates, even as a minor constituent. 
Oxalate stones which, according to Gordon and to Cabot, (6) 
may be derived from oxalate-containing vegetable foods, such 
as rhubarb and sorrel, are not common among Filipinos. While 
Spiegel and others believe that calcium carbonate calculi may 
originate from the excessive use of hard water (as is the common 
well water of the Islands), such stone formations are infrequent 
in this series. I have not found xanthine, urostealith, or fibrin 
calculi, which are occasionally mentioned in the literature. 
