562 MORBID ANATOMY.
ox. of lime, and triple phosph. Exterior smooth. From a horse probably. 4" 2'" by 2" T". 2677. A renal calculus, of immense size, with six small ones.
The case was published in the Boston Med. Intelligen- cer, March 2d, 1824, by Dr. J. Lummus, of Lynn. For two years the patient had had pain in each side, and par- ticularly in the left ; but, until a few weeks before her death, nursed a young infant, and attended to her domestic du- ties. Ten days before death Dr. L. found her prostrated, greatly emaciated, and with a distinct, hard, unyielding tumor in the seat of the pain. " All the viscera seemed healthy, except the kidneys. The left ureter was impervi- ous ; the right I was prevented from examining. I re- moved the tumor on the left side, weighing 4 Ibs. ; con- taining the kidney, thickened peritoneum, and a calculus weighing 19 oz., avoirdupois ; an end of it broken, and presented a smooth fracture ; another calculus weighing oz., and six others, weighing together oz. The calcu- lus in the right side I felt through the thickened peritone- um ; and I judged it was but little smaller than that of the left ; I was not allowed to remove -it."
The body of the large calculus is of an ovoid form, and upon one side regular in its outline. From the other side there project five masses, more or less pedunculated, as usually seen in renal calculi, and varying from the bulk of a chestnut to that of a pullet's egg. The color is whitish, and the surface rough. Weight, 1 lb., 1^ oz. Diameters of the body of the calculus, 5| in., 2^f in., and 2- 6 in. The small calculi weigh 1 oz. ; vary much in form, and in size, from about in. to 1J in. in diameter.
In 1858 the specimen was examined by Dr. J. Bacon : " The portion analyzed was from one of the external nod- ules, which presented, on section, numerous concentric layers, mostly of a yellowish-white color. A friable nucle- us, composed of ox. of lime, with a very little phosph. of lime, occupied the centre. Around this was a series of hard layers, consisting of phosph. of lime, chiefly ; with a little ox. of lime, triple phosph. and carb. of lime. The outer layers, of a nearly white color, and rather friable, were composed of phosph. of lime, with considerable triple
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