ALKALINE DRINKS AS LITHONTRIPTICS. 145 
ART. XXXV. — PRECAUTIONS TO BE ADOPTED IN THE 
EMPLOYMENT OF ALKALINE DRINKS AS LITHON- 
TR1PTICS.* 
It cannot be denied that, in certain circumstances, calculi 
are formed in the bladder under the influence of the con- 
tinued and unmethodical administration of alkaline medi- 
cines. Must it be concluded from this, says M. Bouchardat, 
that bicarbonate of soda is useless, and even dangerous, in 
the treatment of gravel and calculus? Certainly not; but it 
is necessary to know how to aid this powerful means, in 
order that it may render all the services which we have a 
right to expect from it. According to this physician, the 
two indispensable adjuvants of all lithontriptics are: 1st, 
abundant aqueous drinks; 2d, a moderate surrounding tem- 
perature. When alkalis are prescribed, it is not absolutely 
necessary that they should be as concentrated as they are 
generally ordered: 1st, because drinks so powerfully medi- 
cated are not so easily absorbed; 2d, because a sufficient 
quantity cannot be swallowed every day without disgust 
and inconvenience. Thus, for example, the waters of 
Vichy contain much more alkali than is necessary, for one 
gramme of bicarbonate of soda is quite sufficient for one 
qyart of water. 
It is always to the bicarbonates that we should have re- 
course. What greater advantage, indeed, can be expected 
from the subcarbonates and from caustic alkalis? Evidently 
none; for, during the assimilation, they are converted into 
bicarbonates; and it is in this state that they exist in the 
blood. The more caustic alkalis, therefore, present the in- 
convenience of more powerfully attacking the digestive ap- 
paratus without ulterior advantage. When the fatigued 
* Journal de Chimie Medicale. 
13* 
