LITHONTRIPTICS, termed also LITHONTHRYPTICS, or (segos, a stone, and Tp(13€0, to rub or bruise), medicines or other means which are thought to possess the power of dissolving stone or calculus in the urinary organs. The calculous concretions which are apt to form in the kidneys or bladder are of very different kinds, originating in different constitutions or in different habits of life or locality of abode. They are also different, not ouly according to the time of life wheu their formation began, but they often become varied in the pro gress of their increase, and are different in the strata of which they are composed.
It requires, therefore, not only very close investigation into the characters of the urine of a person supposed to be affected with calcu lous concretion, but also no slight acquaintance with the chemistry and physiology of that fluid, and the great influence of the nature of the food and drink on its composition, to be able to direct the use of medicines which are regarded as lithontriptic. With few exceptions, their employment has been nearly empirical ; and aggravation of the MSC has as frequently resulted as benefit from their employment. The researches of recent chemists and pathologists have given some thing approaching to a scientific explanation of the circumstances under which calculi form, as well as of their varied characters ; so that more good may reasonably be expected from the use of lithontriptics than has hitherto been realised. [Cstontes.] Of the twelve or thirteen varieties of calculus concretions which have been discovered in tho bladder or kidneys of the human subject, some are of very rare occurrence, while the more common ones may be classed under two distinct heads—those which form under the prevalence of the uric or lithic acid state of constitution, and those which form under the prevalence of the phosphatic state of constitu tion. These sometimes alternate, and indeed the concretions which belong to the last class have almost invariably a nucleus or centre of the first kind, which shows bow very important it is to avoid the causes of the lithic acid formations.
Independent of constitutional peculiarities, the leading causes of the formation of calculous concretions are errors in diet or regimen. The kidney is the great channel for the expulsion from the system of the azotised or nitrogenous principles of the blood, as well as of many saline particles, which were once an integral part of the body, but now effete ; and to keep these in suspension, so as to ensure their elimina tion from the body, a due quantity of an aqueous menstruum is required. Hence whatever reduces the quantity of urine below the proper standard predisposes to the formation of calculi. Now an excess of animal food, particularly if exercise be neglected, and strong wines—in a word, rich living, with indolent habits—are the frequent origin of calculous complaints. Crude vegetables, with bad clothing and exposure to cold and damp, which interfere with the healthy action of the skin, equally predisposes to the formation of stone, and thus the poor stiller from it as well as the wealthy. The causes being so widely different, the mode of treatment must also be different. A specific cannot therefore exist, and all unskilful tampering with a case must lead to most hurtful results. Medicines taken by the mouth (and such alone can be used where the stone is in the kidney) have been hitherto more successful in relieving the distressing symptoms than solvents thrown into the bladder. There is, however, ground for believing that in certain cases, under competent direction, chemical agents and perhaps galvanism may be made available to dissolve the concretions in the bladder. These agents are quite distinct from any mechanical means for crushing the stone.
(See Brodie, Lectures on Diseases of the Urinary Organs, 2nd ed.; and particularly the very excellent work of Dr. Willis, Urinary Diseases and their Treatment, 1838.)