A treatise on the formation, constituents and extraction of the urinary calculus; being the essay for which the Jacksonian Prize for ... 1833 was awarded / by John Green Crosse.

  • Cross, John, 1790-1850.
Date:
1835
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the formation, constituents and extraction of the urinary calculus; being the essay for which the Jacksonian Prize for ... 1833 was awarded / by John Green Crosse. Source: Wellcome Collection.

    30/366 (page 14)
    of a section of this calculus, and the smoothness of the surface near which the nucleus is found, that the stone had a fixed position in the bladder, always resting upon the part placed lowest in the figure, and that the fresh accretion, composed of the fusible calculus with much animal matter, took place upon the surface open to the urine. From such instances are we not to infer, that, if a stone be fixed, resting uniformly upon one part of its surface, or if it be adherent, or in part con¬ tained in a sacculus, that it will increase chiefly or entirely in the aspect which is free to the access of urine ? What I state may prove sufficient to direct the atten¬ tion of surgeons and pathologists to this interesting point. A patient, in whose bladder a stone had been distinctly felt, assented to undergo cystotomy for its removal; but when a very valued friend of mine4 went to a dis¬ tance to perform the operation, no stone could be found on sounding; the disease wras notwithstanding present, and the patient was worn down by his sufferings, after a year or two more had elapsed. Two calculi were found in his bladder; the smaller one, composed principally of lithic acid, and weighing two scruples, was loose, and presented a regular shape, (plate i, fig. 9, a.) The larger stone (b) has a nucleus of lithic acid of a similar shape to the smaller moveable stone, wdiich nucleus is situated so as to project upon the surface (d,) whilst a very bulky depo¬ sit of the fusible kind, mixed with much animal matter, has taken place in one direction and not all around the nucleus. To afford an explanation of such a partial deposit, we must suppose, that the small flat calculus of dark colour be¬ came caught and firmly held by the muscular fibres of the bladder, which organ being in a very morbid state, the fusible calculus was quickly deposited upon the surface of the nucleus exposed to the urine. If it be admitted that a stone cannot increase at the part of its surface where it is fixed, or sacculated, or kept in close contact with the coats of the bladder, it will follow, that, where we find on a section that a stone has increased by fresh deposit in a particular direction, it was not fixed or adherent to the bladder at such points. A very able surgeon removed, some years ago, from a boy fifteen years old, and by the high operation, a calculus weighing |j Siss, as represented in fig. 8 4 The late Dr. Rigby.