A case of spontaneous fracture of uric acid calculi / by Charles B. Plowright (per W.M. Ord).

  • Plowright, Charles Bagge, 1849-1910.
Date:
[1896]
Catalogue details

Licence: Public Domain Mark

Credit: A case of spontaneous fracture of uric acid calculi / by Charles B. Plowright (per W.M. Ord). Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    also formed of tlie same grey material; they constitute com- paratively thin bridges arching over fissures that extend downwards towards the centre. These bridges vary in height and in width, but on the surface of the calculus, they are in all cases considerably wider than the fissure over which they stretch. The grey deposit extends downwards as a thin granular layer upon the fractured surface of the calculus, covering both sides but not filling up the fissure entirely, and it is here in the interior of the calculus that we find its spherical structure best developed. The thickness of this layer varies, but it is always greatest towards the exterior of the calculus just opposite the first or second or third external lamina, from which point it thins off so as to appear in section as a blunt wedge. On its free surface it presents an assemblage of spheres or of bluntly rounded cones or short cylinders, the bases of which become fused into an homogeneous layer applied to the fractured surface of each segment, so that the planes of the two deposits are at right angles to one another. In order to determine the composi- tion of this granular deposit, a minute fragment was chipped off from the segment of the calculus, placed on a microscopic slide, and covered with a thin cover-glass ; caustic potash was then run in, and the effect watched under a quarter-inch objective. The fragment dissolved in a few minutes. A similar fragment was kindly examined by Dr. Ord in the same manner, who used glacial acetic acid, when that very beautiful reaction took place in which the acetic acid gradually broke up the fragment and then caused the deposit of uric acid crystals with lancet-shaped ends, which he has shown 1 takes place when the uric acid is associated with ammonia, so that this grey granular deposit consists of an acid urate of ammonia. The thick, wedge-shaped mass towards the perqfiiery of the section is evidently the agent that is forcing ajiart the various segments, and it is here at the most external part of the fissures that the only attachment of the segments exists, in fact each hangs suspended by its external angles like Mahomet’s coflin. Some of the fissures have obviously extended from the surface inwards towards the centre, while others have gone in the reverse direction from the centre outwards, as they are wider below than above. The fissures are narrow, and reach inwards as far as the dark nucleus, or, to ^ Ord, W. M., ‘ Iiillucnce of Colloids upon Crystalliuo Form and Colicsiou/ 1879, p, 99.