542 MORBID ANATOMY.
2560. A material that looks not unlike the fragments of a cal- culus, that had been broken up by a lithotrite, and in bulk about four fluid-drachms.
From a gentleman who was first seen by Dr. G. about a year and a half ago. Two and a half years previously he passed about a teaspoonful of fine red sand after con- siderable pain. After this he was relieved for a time ; but in a few weeks he began to have discomfort in passing the urine, and for the next two years this went on, gradually increasing. When Dr. G. saw him, he was passing his urine every hour, or oftener, during the night, and perhaps every fifteen minutes during the day ; and always with great pain. Just before this time, a catheter having been passed, it was found almost impossible to withdraw it. The obstruction was without doubt owing to the calculi ; and, when it was at last withdrawn, the pain was excruci- ating. There was some loss of flesh, and of the appetite, but the patient's general appearance was sufficiently well. The urine had generally been fetid, and had a dirty look ; and once or twice some blood had been passed. On passing an instrument there was felt something like the remains of a disintegrated calculus, or as if it were passing into a sandy beach. A series of operations was then commenced for the removal of the fragments. A very large and per- fectly straight catheter, that was made for the purpose, and with a very large eye, was passed two or three times a week for several weeks. The bladder was always first in- jected with tepid water ; the instrument was then passed ; and, on withdrawing the stopper, more or less of the frag- ments were forcibly discharged. Since the last of them were got rid of, the relief has been complete, though a catheter has always been required.
The fragments that have been preserved, are not quite one-half of the whole amount that was passed. Most of them are very irregular, like bits of dried mortar, and on an average smaller than a dried pea. Many were smooth, rounded, and sometimes hollow ; and many were surrounded by a secondary deposit. When recent, they were generally lemon-colored, and several of them still have a yellowish
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