66 
DR. YELLOLY’S REMARKS ON THE 
the proportion would not be more than 2.2 per annum, or 1 only, for every 
340,000 inhabitants. 
In some parts of the country districts of Bristol, there are very singular 
anomalies ; for the town of Chippenham, with only 3200 inhabitants, is stated 
by Mr. Smith, to have furnished as many cases of lithotomy, as the whole re- 
maining county of Wilts. On the calculation of 18 cases in 82 years, or 1 in 
4.5, which is about half the amount furnished by Wilts, there would, in this 
little town, be a tendency to calculous complaints, exceeding by about a fourth, 
that of Norwich itself. 
Scotland is generally regarded as but little liable to the production of cal- 
culous diseases ; and if Mr. Smith’s calculation, of the occurrence of 8 cases 
only per annum, in that part of the island, is a correct one, it would, on its 
population of two millions, be in the ratio of 1 case for every 250,000 inhabi- 
tants. But the town of Dundee, in the county of Forfar, with a population of 
30,000, has afforded to Mr. Crichton, of that place, in 36 years, 31 cases of 
stone, out of above 70 on which he operated during that period*. This is at 
the rate of .86 per annum, or 1 for every 35,000 inhabitants, if they had ex- 
tended to that number. But if 5 are deducted, as having, from their designa- 
tion in Mr. Crichton’s list, the appearance of belonging to a higher class of 
society than enters into the calculations of this paper, we should then have .72 
per annum, or 1 case for every 41,000 inhabitants, which is about the average 
proportion of Bristol. 
In the instances which I have mentioned, it would therefore appear, that 
the tendency to produce calculous complaints, is greater in towns than in the 
country ; and if this should prove to be the case generally, it would seem to 
indicate the existence, in children more particularly, of a connection between 
some diathesis which prevails in towns, (probably the scrophulous,) and the 
tendency to the secretion or deposition of lithic acid, on which the origin of 
urinary calculi so much depends. I have not bad it in my power to ascertain, 
whether the greater disposition of towns to calculous complaints, applies more 
extensively than I have mentioned. I think it probable, however ; but in 
some cases, in which I had expected to be able to connect the reports of the 
numbers operated upon, in a particular town or district, with a certain known 
* Observations on the Operation of Lithotomy. Edin. Med. and Surg. Journal, vol. xxix. p. 225. 
