Volume 2
A text-book of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the eighth German edition, by special permission of the author, by George H. Humphreys and Charles E. Hackley.
- Date:
- 1880
Licence: Public Domain Mark
Credit: A text-book of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the eighth German edition, by special permission of the author, by George H. Humphreys and Charles E. Hackley. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
75/880 (page 61)
![furnish a nucleus for a phosphatic shell. From the experiments of Studensky, who inserted foreign bodies into the bladders of dogs and put lime into their food, it would seem that an excess of lime in the food predisposes toward phosphatic calculi. Even the phos- phates which properly exist in the body may by morbid and exces- sive transformation produce stones in the urine, as sometimes hap- pens in osteomalacia. Gravel and stones form at all ages of life. In childhood, how- ever, the disposition toward stones—perhaps through uric-acid in- farction of the new-born—seems the greater ; and in old age it is also common. That men should suffer more often than women would seem to be because of their different modes of life. How much geological and climatic influences have to do with endemic tendency to stone in certain countries, as England, Holland, and parts of Germany, has not been made clear. Concretions rarely form in the kidney-substance proper ; but cases like those of uric-acid infarction of the new-born have been seen in the adult, in which uric acid was found after gout, haema- toidin crystals after haemorrhage, and bile-pigment after jaundice. Carbonate of lime, too, has been met with. Real stones are also found as very great rarities in the kidney proper, or rather in por- tions of the dilated urinif erous tubules. The ordinary seat of gravel and of stone is in the calyces or pelvis of the kidney. The smaller stones are roundish ; larger ones mould, themselves to the shape of the region which they occupy, so that stones of the calyx acquire a pyramidal form.] Stony concretions form in the pelvis of the kidney, probably under the same conditions which cause them to form in the bladder. When treating of vesical calculus, we shall discuss the pathogeny and etiology of these calculous formations more fully. Many, and perhaps the majority of stones in the bladder, originate in the pel- vis of the kidney, and pass thence through the ureters into the blad- der, where they increase in size by precipitation from the urine. Anatomical Appearances.—In cases of uric-acid infarction, upon section through the pyramid, we see delicate yellowish-red stripes running in the direction of the tubules. Upon microscopic examination, these tubules are found to be filled with a blackish, coarsely-granular material. Upon the addition of an acid, these masses disappear, and are replaced by crystals of uric acid. Ac- cording to Virchow, dilatation of the tubules and the formation of cysts in the kidney of the foetus may arise from permanent obstruc- tion of the efferent tubules. In the haemorrhagic-pigmentous in- farction we also see red streaks, with a tinge of yellow in them, in](https://iiif.wellcomecollection.org/image/b21981772_0002_0075.jp2/full/800%2C/0/default.jpg)
