As soap was with reason supposed to add considerably to the virtues of the lime, it led to the use of the caustic alkali, softened by a more pleasing mucilage, veal broth. Since that time it has been used alone.

The following is the best mode of preparing and administering it:

Take of kali prepared, eight ounces; of fresh quicklime, four ounces; of distilled water, a quart: mix them well together in a large bottle, and let them stand for twenty-four hours; then pour off the ley, filter it through paper, and keep it in well stopped phials for use. Of this the dose is from thirty drops to two drachms, which is to be repeated two or three times in a day. Mix the quantity to be used in the day with three pints of plain broth, which has been made with the lean part of veal, all the fat or oily parts being separated from it, by putting it, when made, into a large bowl, and skimming them off with a spoon when cold, and let the patient drink within an hour a pint of this broth three times a day, early in the morning, at noon, and in the evening: continue the use for three, four, or more months, living during this course on such things as least counteract the course of this medicine.

Various other lithontriptics have been employed; but the calculus seems a more uniform concretion than has been supposed, particularly by Dr. Dawson in the London Medical Transactions, vol. ii. p. 105. The common fixed alkali, or, in stricter language, the carbonated alkali, has been employed; and, more lately, the alkaline carbonated water, viz. the alkali with an excess of carbonic acid. Some cases have been related, in which this remedy has been employed with success, and we may easily find a foundation for its use.

Honey has been used also with success; and Mr. Home, surgeon at the Savoy, has recorded its utility in his own and his father's cases. It was an ingredient in Mrs. Steevens' farrago, but in loo small a proportion to be of advantage. Bitters have been also employed, and we have already mentioned their use as preventives: we have reason to think that they may be serviceable in mitigating and protracting a fit.- When we reflect on these different means, we shall perhaps find only the pure alkali and the lime water adapted for the solution of the calculus; and, when the circuitous course of each is considered, we may suspect that they seldom reach the bladder without impaired virtues. We have, indeed, two instances in opposition; but, without offence to either, may we not suspect a little predilection in favour of the remedy to have influenced the observation ? It once happened in a clinical ward, that the urine was reported to effervesce with alkalis. Some of the elder students, in private, suggested that they could perceive no effervescence but the slight separation of air, occasioned by the mixture of any two fluids. On the next day it was reported that no effervescence had taken place, nor could it, adds the professor, for the alkali was caustic. What adds to our scepticism on this subject is, that from the use of lithontriptics the symptoms have been often relieved, though the stone has remained without any change.

When we reflect on the connection of stone with gout, on the weakness of the stomach, apparently the origin of each, and the utility of bitters, stimulants, and antacids, we own that we rest with more confidence on the idea of the whole originating in imperfect digestion, and the production of an animal oxide not admitting of application as a nutritious substance. But, whatever becomes of the theory, lime water and soap, acidulous soda water, caustic alkali, or bitters, are highly useful. Of the soap as much must be taken as the stomach will bear,or as much as will prove gently laxative; but of the lime water few can take more than a pint daily. The acidulous soda water may perhaps be taken in larger quantities, as it is more agreeable; and the acidulous salt is now prepared, so as to produce this water extemporaneously. It must, however, be swallowed while dissolving, as the carbonic* acid gas rapidly escapes. Of the liquid caustic alkali, from thirty to a hundred and twenty drops may be taken in veal broth two or three times a day.

The inconveniences arising from the use of large quantities of soap and lime water are, impaired digestion, and, consequently, debility and emaciation. With the superfluous, the necessary acid seem to be destroyed. This effect has not, however, followed the soda with an excess of carbonic acid; though the bitters are suspected, by long continuance, of diminishing the tone they were intended to preserve. Generally speaking, therefore, these remedies should not be continued long without intermission: yet they will not soon produce a change; and a trial of three months is at least necessary. If no benefit is then obtained, they should be relinquished or changed. If any amelioration of the symptoms should be observed, they may be pursued longer; yet in no case, probably, beyond nine or twelve months, without some intermission, or interposing a warm tonic for a few weeks. As the management during the paroxysm has much engaged the attention of physicians, we shall add the outlines of what has been directed.

During a fit, if the habit is plethoric and sanguine, Herding both guards against and removes inflammation. Those persons who are subject to regular returns, may lose blood a little before the expected period.

Diuretics should never be of the stimulant kind; the emollient and oily are the most proper; and after these, the diluents should be freely employed. In general, the more painful the fit, the gentler should be the diuretics, and the less copiously given. The aged and weak should be allowed the use of cordials with their diuretic medicines. When the pain and spasms are very violent, and yet there is hope that the stone will pass the urinary ducts, gentle diuretics, mixed with mild anodynes, do the greatest service: for the latter relax the parts and ease the pain, and the former more easily and safely propel the stone. When gravelly matter hath been seen to be discharged with the urine, and to subside presently after it is made, light steel waters, either of the purging or of the diuretic kind, \ cry safely and effectually expel it, and strengthen the kidneys: the water should be continued some weeks, and repeated at proper intervals. But if a stone in the kidneys is so large that there are little hopes of its passing through the ureters, which is known from the continuance of the disease, the steel waters should not be used.