564 MORBID ANATOMY.
Composition of the calculus, according to Dr. White : phosph. of lime chiefly, with some ox. of lime, and a trace of triple phosph. of ammonia and magnesia. 1869.
Dr. R. M. Hodges.
2680. A large ovoid calculus, and another much smaller ; re- moved from a sac in front of the bladder.
The patient, a laborer, thirty-three years of age, had stricture nine years before, and that was relieved by dila- tation ; but from that time he had been in the habit of passing, occasionally, an elastic catheter (about No. 5). Nov. 5th there was difficulty of micturition, and a small swelling appeared in the perineum. On the 7th, after a cold ride, the swelling became painful, and from that time increased.
On the 14th he was seen by Dr. J. Spalding, of Lowell. The swelling was then larger than the fist, and the whole scrotum and penis were infiltrated with urine. On the right side there was a urinary fistula, that had existed for nine years, and upon the left side the cicatrix of one that had healed. The bladder was not distended ; and every hour or two the man drew off a considerable quantity of urine by .the catheter ; the flow being quite free when the instrument was passed down to near the membranous por- tion of the urethi'a, and it being evident that it did not enter the bladder. The strength and pulse were fair. An incision along the raphe, and just below the scrotum, was followed by a gush of about iij. of urine ; and the cellular tissue was found extensively gangrenous. ^The calculus was then felt firmly imbedded in fibrous tissue ; and, the anterior wall of the sac in which it lay being incised, it was with considerable difficulty separated from the walls and withdrawn. At least a pint of urine immediately escaped. A fa^ette, showing that there was a second cal- culus, this last was felt and easily removed. The largest calculus measured 5 T 3 6 in. in its largest, and 4 in. in its smallest circumference ; diameters of cut surface, If in. by 1| in. Weight, 740 grs., Troy. Structure compact; and of a light-yellowish color. Distinctly, though not strongly, laminated upon the cut surface ; the laminae being darker than the rest, and quite hard. External surface
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