LITHONTRIP'TICS (from the Greek words lithos, a stone, and tribo, I wear out) is the term which is applied to those remedies which, whether taken by the mouth or injected into the bladder, act as solvents for the stone.
Various medicines have at different times been recommended and employed as sol vents for the stone. Rather more than a century ago, limewater and soap, when swal lowed in sufficient quantities, had a high reputation as solvents for urinary calculi. These were the only active ingredients in Miss Stephens's Receipt for the Stone and Gravel, which was reported on so favorably by a committee of professional men that parliament, in 1739, purchased the secret for £5,000. The treatment doubtless afforded relief ; but there is no evidence that any calculus was actually dissolved, for in the bladder of each of the four persons whose cure was certified in the report the stone was found after death. At present no substance which, taken by the mouth, has the power of dissolviny calculi is known; but as Dr. Prout remarks in his well-known treatise, On the liaturb and Treatment of Stomach and Urinary Diseases, remedies of this class are to be sought " among harmless and unirritating compounds the elements of which are so associated as to act at the same tiine, with respect to calculous ingredients, both as alkalies and acids." Solutions of the supercarbonated alkalies containing a great excess of carbonic
acid—as, for example, the natural mineral waters of Vichy—approach most nearly- to what is required. The relief which, in many in.stances, has followed the administration by the mouth of substances supposed to bo lithontriptics has been derived not from the solution of the calculi, but from the diminution of pain and irritation in the bladder.
On the other hand, considerable success has been obtained by the direct injection of solvents into the bladder, especially when the nature of the calculus is suspected; weak alkaline solutions have apparently caused the disappearance of uric-acid calculi, while phosphatic calculi have unquestionably been dissolved by the injection of very weak acid solutions. It is reported that a weak galvanic current has been recently found successful in the hands of au Italian surgeon.