In this division of the subject there is still room for further i study and information, more especially in relation to the origin of calculi. In our series of cases the stone in nearly all was comparai tively small, especially in those of the children, the smallest (Mr. Heath's case) weighing but ten grains. On the other hand, the stone removed by Mr. Henry Thompson weighed two ounces, and that by Mr. Partridge probably more. In the remarkable case at St. George's, wherein the bladder

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... three calculi, the largest weighed five ounces and a quarter, whilst the two others weighed two drachms each. The composition was made out in most cases, and all the ordinary varieties of calculus were represented. The analysis of the stone in Mr. Wakley's case is particularly interesting and valuable, I for it showed it to be chiefly composed of the urate of lime--a rare form. Were this plan more generally carried out, the clinical value of the cases would be enhanced, if associated ( with the previous symptoms and an analysis of the urine. Calculus is often hereditary, and cases are recorded where I members of the same family in three successive generations have been cut for stone. This peculiarity is somewhat exemplified in the child from whose bladder a calculus was removed by Mr. Teevan. We would ask, Cannot more be done by wellregulated medical treatment and regimen to either completely remedy or keep in abeyance this peculiar diathesis ? P. P-, aged sixty-three years, an agricultural labourer from Hampshire, whose case was taken as follows by Mr. Hooper, Mr. Thompson's dresser :-The patient has had symptoms of stone for nine years, but very severely of late. He had been sounded several times without detection of the stone ; lately, however, it had been discovered by Mr. Perry of Droxford, who sent him to Mr. Thompson, by whom he was exa-' , mined at the hospital on the l8th of June, 1864. He is the subject of hypospadias, with considerable narrowing. On introducing a small sound, a heavy stone was struck. The narrowing was then divided with a bistoury so as to enable a lithotrite to pass into the bladder for the purpose of measuring the stone. It proved to be two inches long, and Mr. Thompson stated that he should not entertain the idea of lithotrity, on account of the narrow urethra and the considerable magnitude of the stone, but perform lateral lithotomy. The patient was ordered a pint and a half of the decoction of triticum repens daily. In two or three days his symptoms were greatly relieved, and he improved very much every way during the ensuing fortnight. July 8th.-Mr. Erichsen holding the staff, Mr. Thompson performed the operation in the following manner. He commenced the incision close to the left side of the raphe, an inch or an inch and a quarter in front of the anus, and, carrying the knife in deeply at once, brought it out in a diagonal line towards the hip, so as to make an incision three and a half inches long. The staff, being nearly exposed, was entered at once, and the knife carried on, and brought out by a gentle sweep along the outer angle of the wound. The finger followed, and the forceps was introduced upon it. A large stone was easily caught, and brought carefully through the neck .of the bladder. It proved to be uric acid, of the usual oval form, and weighed two ounces. The bleeding was rather free; a superficial vessel was tied, and the wound plugged with lint round a tube. 10th.-He has not had a bad symptom. Takes milk and egg freely. Tube removed. No bleeding has taken place. 13th.—Takes his chop daily for dinner. 16th.-Going on well; wound healing. 22nd. -Phosphatic matter collects on the track of the wound. To have an acid lotion and a hip-bath night and morning. 25th.-Wound quite clean. The urine passes by the natural channel. Walks about the ward. August.-He was discharged cured, with the wound healed, in the early part of the month. , the resident medical officer of the hospital. One was the prolapse of the rectum, evidently the result of the constantly straining efforts in passing urine, associated with a want of muscular tone in the bowel of a strumous, weakly child. The other was the composition of the calculus. The first of these was completely cured by the removal of the irritating body, the chief exciting cause. Urate of lime is described by Dr. Hassall, in his work on the Urine, as frequently met with, and as entering largely into the composition of urinary deposits. It has been found, he states, though somewhat rarely and in small quantity, in certain urinary calculi, especially the phosphatic. A calculus, therefore, composed almost wholly of that salt, with traces of other urates, is a circumstance of much interest and rarity, and is a contribution of value to the pathology of the urine :-William L-, aged four years, a weak, badly-nourished child, of strumous diathesis, was admitted into the hospital, suffering from the following symptoms of stone in the bladder -viz., pain and frequency in passing urine, elongation of the prepuce, and prolapsus of the rectum. The child had suffered five or six months with irritability referred to the bladder; but during the three weeks prior to admission the prolapse of the bowel was first observed, and, as it daily increased, the parents of the child became alarmed, and were induced to seek advice at the hospital. As far as could be ascertained there was no hereditary tendency to the disease in the family. On examination, a calculus was detected lying at the base of the bladder. The patient was kept in bed for a fortnight, for the purpose of allaying the irritability of the bladder and reducing the prolapsus of the rectum, and with the combined assistance of rest, gentle pressure (locally applied to the rec. tum), alteratives and tonics (to improve the health), the general condition of the child became so much improved that Mr. Wakley determined to perform the usual operation for the removal of the stone on the l4th of September. Chloroform was administered, and Mr.Wakley performed the lateral operation, and a calculus weighing rather more than a drachm and a half was readily removed. Very little blood was lost during the operation. The child progressed without a bad symptom. The urine passed partly by the urethra on the seventh day after the operation, and on the fourteenth no urine flowed through the wound. The wound in the perineum had completely healed on the twenty-first day. The prolapse has not appeared since the removal of the stone, and the child was discharged in good health, and has continued so to the present time (Dec. 18th). Analysis of the stone.—The following report of the analysis of the stone was furnished by Dr. Hassall :-The calculus weighed 94.1 grains, or rather more than one drachm and a half, and it had a specific gravity of 1 '53. It was smooth and polished externally, oval and flattened, and had all the appearance of a stone or pebble which had been subjected to the action of water-a form, indeed, impressed upon it by the constant rolling motion of the stone in the urine. Internally it presented a laminated structure. It was found to consist almost entirely of urate of lime, with a little urate of magnesia, a trace of urate of soda, and a small quantity of phosphate of lime and of triple or ammonio-magnesian phosphate. The calculus was tested for oxalate of lime, so often found associated with uric acid and the urates, also for potash, but not a trace of either was present. A few years since this calculus would have been described as consisting of urate of ammonia ; and, indeed, although uric acid is rarely found in any quantity in combination with the volatile alkali, yet uric acid deposits are still very commonly, but erroneously, spoken of and described as composed of urate of ammonia.