North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
"_The calculus composed of a mixture of the phosphate of lime
and triple phosphate of magnesia-and-ammonia, or the fusible
calculus_, is commonly whiter and more friable than any other
species, resembling sometimes a mass of chalk, and leaving a
white dust on the fingers. This species is generally not
laminated. Occasionally, however, it separates readily into
laminae, the interstices of which are often studded with
sparkling crystals of the triple phosphate. The variety of this
species which is not laminated often acquires a very large
size, and assumes the form of a spongy friable whitish mass,
evidently moulded to the contracted cavity of the bladder in
which it has been formed. This species of calculus occurs very
frequently.--_Chemical characters._ It may be readily
distinguished by the ease with which it melts before the
blow-pipe. It also dissolves readily in acids, and particularly
in dilute muriatic acid; and if to the solution, oxalate of
ammonia be added, the lime is precipitated alone, and the
magnesium may be afterwards separated by the addition of pure
ammonia.
"_The alternating calculus_, as the name imports, may consist
of different layers of any of the preceding species. Hence its
general appearance, texture, &c. will depend entirely on the
composition, and may be very varied. Most commonly it is
composed of a lithic acid or mulberry nucleus, and an external
crust of the fusible calculus. In some rare instances, it is
composed of laminae of all three of these substances, and
sometimes of even more--the mixed phosphates still continuing
to constitute the external crust. This species of calculus
often acquires a very large size and is very common.--_Chemical
characters._ The chemical characters must of course vary with
the composition; and as the different substances of which it is
composed must almost certainly be some of the preceding, the
nature of the different laminae can be readily ascertained by
what has been already stated," p. 79, et seq.
In the chapter on the comparative prevalency of different forms of
urinary deposite; and the order of their succession, we have a number of
important facts and observations. Dr. PROUT calculates, from the data
collected by him, that about one-third of the urinary calculi which
occur, are of the lithic acid species, and that another third are formed
on a nucleus of this acid. Hence, "we may assert," says he, "that at
least _two-thirds_ of the whole number of calculi originate from lithic
acid; that is to say, if a lithic acid nucleus had not been formed and
detained in the bladder, two persons at least out of three, who suffer
from calculus, would have never been troubled with that affection. This
is a most important fact, and deserves to be constantly borne in mind."
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