Transactions of the Pathological Society of Philadelphia . ecognizedat any time subsequent to the emaciation, which began during hisabsence from the city, in the summer, and which so impressed mewhen I first saw him, some time after his return. The practical hintto be deduced from it is that frequent examinations of the abdomenshould be made in cases of suspected impacted calculus. A second interesting question refers to the cause of the peculiar spi-ral, corkscrew twist in the calculus in the left ureter, and the approxi-mation to this appearance in the constrictions in the stone in the right
Transactions of the Pathological Society of Philadelphia . ecognizedat any time subsequent to the emaciation, which began during hisabsence from the city, in the summer, and which so impressed mewhen I first saw him, some time after his return. The practical hintto be deduced from it is that frequent examinations of the abdomenshould be made in cases of suspected impacted calculus. A second interesting question refers to the cause of the peculiar spi-ral, corkscrew twist in the calculus in the left ureter, and the approxi-mation to this appearance in the constrictions in the stone in the rightureter. At first I was inclined to account for this by some peculiarityin the mode of deposit; but could it not have been the result of thesolvent action of the urine as it trickled round the stone in seeking an9 130 THE GEXITO-URINARY APPARATUS. outlet from the pelves of the kidneys through the ureters, the luminaof which were so tightly filled by the calculi ? Support to this possi-bility is afforded by the fact that the stones are phosphatic, and that. the urine was kept acid more or less constantly by the benzoic acid,and by the fact that there were no concretions in the kidneys them-selves and their pelves—only in the lower halves of the ureters. A third point of interest bearing upon the termination of the casewas the relation of the walls of the left ureter to this spiral channellingof the stone contained in it. They were closely applied to it, as thethreads of a female screw are to those of the male screw which passesthrough it. Hence the impaction was complete, and it was impossiblefor this calculus to descend farther. The impaction of the stone in THE GENITOURINARY APPARATUS. 131 the right ureter was almost as complete, and it was impossible to moveeither until the ureter was slit up, while with great difficulty were thefolds reached which applied themselves to the spiral channels. Fourth, certain recurrences of stone in the bladder receive a lucidexplanation by thi
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectmedicine, bookyear188
