In many cases, the adhesions which are induced by the inflammation, will secure a more fortunate result, favoring the working of the calculus, by the ulcerative process, either into the duodenum or colon, and thus, in most cases, securing its passage per anum. In such instances, should an opportunity be had of examining the parts after death, traces will be found remaining, sufficient to indicate the point at which the escape into the bowel was effected. In some rare instances, gall-stones have been vomited from the stomach. While it might be possible for such bodies to be carried from the duodenum into the stomach by a reversed peristaltic action, it is more probable that, in such cases, the calculus has found its way into the stomach by a direct fistulous communication with the gall-bladder. Fistulous communications of a permanent character are sometimes left, after an ulcerative discharge of a gall-stone into some portion of the intestinal canal. Gall-stones, after entering the intestinal canal, may become impacted, thus producing intestinal obstruction. Many fatal cases of this character have been reported. An interesting case of intestinal obstruction from this cause, was reported by Dr. Frieze, of Harrisburg, at the meeting of the American Institute of Homœopathy, in Philadelphia, in June, 1871. A lady sixty-five years of age, had been suffering severe pain in the bowels for over a week, with symptoms of obstruction, when, after a persevering use of injections, she passed a calculus of a cylindrical form, one and three-quarter inches in length, and four and one-half inches in circumference, and weighing four hundred and thirty-seven and one-half grains.[29] Gall-stones have, in a number of cases, been discharged upon the surface of the body, while in some rarer instances, by the ulcerative process they have worked into the ureter, and even into the vena cava and portal vein. CHAPTER II. THE URINARY APPARATUS. Section I. THE KIDNEYS.