Three lectures on the surgical treatment of stone in the bladder : delivered in the Royal College of Surgeons of England, June, 1886 : also the address on the etiology and distribution of stone in the bladder, delivered at the Annual Meeting of the British Medical Association at Norwich, August, 1874 / by William Cadge.

  • Cadge, William, 1822-1903.
Date:
[1886?]
Catalogue details

Licence: Public Domain Mark

Credit: Three lectures on the surgical treatment of stone in the bladder : delivered in the Royal College of Surgeons of England, June, 1886 : also the address on the etiology and distribution of stone in the bladder, delivered at the Annual Meeting of the British Medical Association at Norwich, August, 1874 / by William Cadge. 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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    acquiring 1he lithic diatliesis ; of others who lose the tendency imme- diately they leave the county, and of others whose tendency varied with their residence even in the district while the habits of living have re- mained thn same ; that I know not how to doubt the effect of the drink, ing-water oq them. Against this view, it has betn urged that, if haid waters had any effect, they would show it in males and females equally; that hard waters prevail largely over eoft in most places, and that the drinking of hard waters predisposes rather to the oxalic and phosphatic than to the lithic diathesis. In reply to the first objection, it may be said that all influences act more powerfully on men than on women, and that renal, if not vesica], calculus is frequent amongst women; that, although three-fourths of all drinking-waters may be hard, the waters coming from the chalk may have some special peculiarity, and that, in other places, as in lieland, the hard waters may be counteracted by other favourable circumstances of food and drink. Moreover, in the midland districts, where, I believe, the water is very hard, I have shown that stone is also very prevalent. As to the effect of hard water in hading to the oxalic or phosphatic diathesis, as described by Dr. G. Harley and Dr. Murray, I can only say that, in my experience, it is not the fact in this district. I have now operated for stone in nearly 200 cases, and I can only call to mind three cases in which oxalate of lime calculi were removed from adults, and these cases were curious; in one, the central half of the stone is pure uric acid, and the outer half oxalate of lime; and this patient lelt Norfolk, probably with an uric acid stone in his bladder, to reside in North Wales, and immediately the uric acid became covered with oxalate of lime ; the second case was in a Norfolk man, who also had resided out of the county ; and the third was a private in a Dragoon regiment, who had very recently come to live here. I leave this question of the effect of hard waters, therefore, as an un- decided one, requiring fuller inveshgation, and especially the tracing the absence or prevalence of stone in other countries and connecting it with local influences or endemic causes. Lastly, I have to say a few words on hereditary tendency and family predisposition as a cause of stone in this country; and here I cannot help believing we have an influence acting slowly but potently. I can understand, and would maintain, that the hereditary influence must be but slight as to its immediate effects, and must probably require the other favouring influences mentioned to act at all; but with them, in the course of generations and centuries, it would probably so grow and develop as tc create in part the admitted abundance. Let me put the proposition in another way. Could we remove the present population ot Norfolk into Ireland, and import the same number of Irish into JNorloJk, It is probable that no great change would quickly follow in the respective manifestations of the lithic diathesis; but it is most pro- bable that, in course of time, owing to the absence of endemic influ- ences, the Norfolk diathesis would not maintain itself in Ireland, and the Irish substitutes here would as certainly acquire our tendencv I for *° tli^s point, and therefore I may be excused for again referring o my own experience. I have never operated on fa herir^ K^':' ''^'^'^ diseaL back to Ind in fonr^ntb -^^f'- ^T' i^^^^r^c.s, I have operated on brothers; and in four other instances I have operated on one brother and other surgeons on another. Mr. Clubbe, of Lowestoft, has gTven us a cur ous Clubbl . VrT-'^'^l''- cut^for stone by Mr C ubbe , a fourth passed a stone ; a fifth child died, aged three months ani birdVuS^t'r^r' '^'7'^'° f'''' ias'vesical irdtation ouaiif ?f«/.f r f^^* -Pj^^^tli ind mother are constantly passing large motW Z n grandfather passed one stone, and thefranT mother seven ; a great-uncle was cut for stone, and s.x uncles and four