Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 4: Pla [corr.: Ple] - Wri
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit29465/1298/
1288 
URINE. 
pure triple phosphate is still less; thus in 
Bartholomew’s Hospital the proportion is as 
1 : 129 ; in Guy’s, as 1 : 43£ ; in the Bristol, 
as 1 : 218 ; in Copenhagen, as 1 : 19|—. 
The other museums contain no specimen. 
The general relation of the triple phosphate 
in all the collections, is as 1 : 126f. 
“ On the other hand, the proportion of cal¬ 
culi composed of the mixed phosphates is 
very considerable ; thus, in Bartholomew’s 
Hospital, the proportion is as 1 : 12T% ; in 
Guy’s, as 1 : 3£+ ; in the Norwich, as 
1 : 19—; in the Manchester, (including those 
containing a little lithic acid,) as 1 : 8£ ; in 
the Bristol, as 1 : 12 + ; in Swabia, as 
1 : 11J+; in Copenhagen, as 1 : 19f. The 
relative proportion of the mixed phosphates 
in all the collections is as 1 : 12^-f. 
“ Under the head of the phosphates are 
included a few rare specimens of other cal¬ 
culi, e. g. carbonate of lime and siliceous cal¬ 
culi. Of these two varieties, there is only 
one of each reported to exist in the Copen¬ 
hagen collection ; and one containing silex in 
the Norwich collection. 
“ The general proportion of all the calculi 
arranged under the heads of the phosphates, 
in the different museums, is as 1 : 10—. 
“ 5. Of alternating calculi. — Calculi com¬ 
posed of different layers constitute by far the 
most frequent results of urinary diseases ; of 
the successive forms assumed by which, they 
may be said to constitute the index. We 
shall first consider the relative proportions of 
the calculi composed of two, three, and four 
deposits ; and afterwards of the whole con¬ 
jointly. 
“ The proportion of alternating calculi com¬ 
posed of two deposits is, in Bartholomew’s 
Hospital, as 1 : 2\— ; in Guy’s, none are 
reported, probably on account of the calculi 
not having been divided ; in Norwich, the 
proportion of alternating calculi composed of 
two layers is stated to be as 1 : 2f— ; in 
Manchester, as 1 : 2f ; in the Bristol, as 
] ; 3— ; in Swabia, as 1 : l£+ ; and in Co¬ 
penhagen, as 1 : 2\—. The proportion of 
alternating calculi composed of two layers, in 
the conjoint collections, is as 1 : 2f+. 
“ The proportion of alternating calculi com¬ 
posed of three deposits, is, in Bartholomew’s 
Hospital, as 1 : 6— ; in Guy’s Hospital, none 
is reported ; in the Norwich Hospital, the 
proportion is as 1 : 6-f- ; in the Manchester, 
as 1 : 26-f- ; in the Bristol and Swabia collec¬ 
tions, none is reported ; in Copenhagen, the 
proportion is stated to be as 1 : 4£—. The 
proportion in all the collections, is as 1 : 8-§—. 
“ Alternating calculi composed of four de¬ 
posits are only reported to exist in the Nor¬ 
wich Hospital, and the proportion stated is as 
} ; 26|+. In the different collections there 
are twenty-four alternating calculi, the com¬ 
position of which is not stated. The propor¬ 
tion of all the varieties of alternating calculi 
in the different collections, is somewhat more 
than one-half ; that is, as 1 ; 2—, 
“ 6. Of mixed or compound calculi. — In one 
sense of the term, all calculi may be said to be 
mixed or compound, as there are perhaps none 
absolutely pure, i. e.y formed of a single in¬ 
gredient. But in the sense in which the term 
is here applied, namely, as expressive of cal¬ 
culi composed of different ingredients mixed 
together in large or nearly equal proportions, 
compound calculi may be said to be rare. The 
most usual mixtures consist of the lithate of 
ammonia and of lime ; of the oxalate, car¬ 
bonate, and phosphate of lime ; of the lithate 
of ammonia, and the mixed phosphates, &c. ; 
and such mixtures are usually confined to 
small calculi or calculous nuclei. Calculi 
composed of pure lithic acid, or of any other 
pure ingredient, with the phosphates or other 
compounds, do not appear to exist ; at least 
I have met with no such mixtures. 
“ Lastly, it remains to make a few remarks 
on the order of calculous deposits ; an inquiry 
that throws considerable light on the laws of 
their formation and general pathology. 
“ On reference to the table it will be found, 
that in the different alternating calculi, the 
ratio in which the oxalate of lime succeeds to 
lithic acid, is as 1 : 15J-+ ; on the contrary, 
that the ratio in which lithic acid succeeds to 
oxalic acid, is as 1 : lS/g-. Hence the alter¬ 
nation of the two ingredients may be con¬ 
sidered as nearly equal. It will be found, 
however, that the oxalate of lime succeeds to 
the lithate of ammonia, &c., more frequently 
than to lithic acid ; thus the ratio in which 
the oxalate of lime succeeds to the lithate of 
ammonia was 1 ; 9f—. On the contrary, the 
ratio in which the lithate of ammonia succeeds 
to the oxalate of lime, is only as 1 : 38 ; a 
very striking distinction. The ratio in which 
the phosphates succeed to lithic acid, is as 
1 : 9±— ; in which the phosphates succeed to 
the lithate of ammonia, is as 1 : 12J— ; and 
in which the phosphates succeed to the oxa¬ 
late of lime, is as 1 : 7£+. On the contrary, 
three instances only occur in which the lithic 
acid or lithate of ammonia succeeds to a 
phosphate ; and the proportion in which the 
oxalate of lime succeeds to the phosphates is 
as 1 : 253£ only. The general proportion in 
which the phosphates succeed to the other 
ingredients in all the collections, is as 
1 : 4^5+• Hence the generality of the im¬ 
portant law alluded to in various parts of this 
volume, that in urinary calculi a decided depo¬ 
sition of the mixed phosphates is not followed by 
other depositions.” 
The following table, constructed by Dr. 
Prout, illustrating the frequency of calculous 
affections at different ages, and in the different 
sexes, is from a paper published by Mr. Smith 
in the eleventh volume of the Med. Chirurg. 
Transactions, and from “ A Treatise on the 
Formation, Constituents, and Extraction of 
Urinary Calculi. By John Green Crosse, 
Esq., Surgeon to the Norfolk and Norwich 
Hospital. London, 1835.”
        

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