. Modern surgery, general and operative. encrusted with urinary salts and constitute a nucleus forstone formation. Diagnosis, Symptoms, and Treatment.—Diagnosis is made by the history,if given correctl), of the case. The stone-searcher, the .r-ray, and the cysto-scope are most useful in diagnosis. The symptoms are similar to those of stonein the bladder. The treatment is removal, with subsequent care of the resultantcystitis. Vesical Calculus, or Stone in the Bladder.—The salts normally in solutionin the urine may become deposited as calculi and may be imprisoned in anyportion of the urinary t
. Modern surgery, general and operative. encrusted with urinary salts and constitute a nucleus forstone formation. Diagnosis, Symptoms, and Treatment.—Diagnosis is made by the history,if given correctl), of the case. The stone-searcher, the .r-ray, and the cysto-scope are most useful in diagnosis. The symptoms are similar to those of stonein the bladder. The treatment is removal, with subsequent care of the resultantcystitis. Vesical Calculus, or Stone in the Bladder.—The salts normally in solutionin the urine may become deposited as calculi and may be imprisoned in anyportion of the urinary tract. The commonest primary calculi are those com-posed of uric acid, urates, calcium oxalate, and fusible phosphates. In 80 percent, of cases primary calcuH are composed of uric acid and urates. A primarycalculus may become coated with another material (secondary calculus).The formation of uric acid and urate calculi is explained under Renal Calculus(seepage 1427). Vesical calculi are usually renal calculi that have passed through. Fig. 966.—Stone in bladder shown by .v-rays. the ureter and become enlarged by new accretions. New accretions from analkaline urine will cause the formation of a secondary phosphatic stone. Phos-phatic calculi may be formed in the bladder when chronic cystitis causes andmaintains an alkaline urine. Uric-acid calculi are smooth, round or oval, andhard, but easily broken. On section they present the color of brick-dust andare marked by concentric rings. Their nuclei are dark by comparison. Theyare soluble in dilute potassium hydrate and in nitric acid. They are com-bustible and leave scarcely any ash. Urate of sodium and urate of ammoniumoften occur together in stones, and these calculi are not in rings, are not so hardas the uric-acid stones, and are fawn colored on section. Oxalate of lime stonesare round, with many projecting nodes like the mulberry, hence the term mul-berry calculus. They are very hard, and section shows the color tobebrowTi
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