A fit of the Gravel may sometimes be mistaken for Lumbago; but it may be distinguished by the nausea, by the change in the urine, and the pain continuing unaltered by any variation in the posture of the body. Attention to the same symptoms will also serve to distinguish gravel from a fit of the Colic, with which also it is liable to be confounded. Disordered affections of the prostate gland are those which, without proper attention, are most likely to be mistaken for Stone in the bladder. One mark of distinction is, that in the prostate affection, the pain experienced in making water will be always at the commencement, while, on the contrary, it is most usually during the passage of the urine, or when the bladder is nearly emptied, that pains and obstructions are perceived in cases of Stone. Another important symptom of Stone is, that the irritation which it causes does not so much affect the general health, as the same degree of local disturbance from other causes. When Gravel has once formed in the kidneys or elsewhere, it continues to increase by receiving on its surface new layers of Uric Acid deposited from time to time. With Stone in the bladder, the patient cannot bear any kind of rough motion; neither can he use any severe exercise without enduring great torture, and, perhaps, bringing on either a discharge of bloody urine, or some degree of temporary suppression.

The long continued irritation of the coats of the bladder by the Stone, produces a considerable thickening in their substance, but principally in the muscular coat, its fibres becoming large and incapable of that dilatation which they formerly possessed; their irritability, however, increases, so that they are excited to contract upon a few drops of urine, and thus, by pressing the stone against the part, already too sensible to pain, an almost constant state of suffering is kept up. The bladder, in time, becomes more diseased, the inner coat constantly inflamed, and sometimes ulcerated; all the unfavorable symptoms increase, and, unless an operation is performed for the removal of the stone, the patient's sufferings are only ended by death.

As all attempts to dissolve a stone in the kidneys or bladder have hitherto proved ineffectual, we are to consider the disease only to be removed in males by either cutting into the bladder or by crushing the stone in the bladder; the latter operation should only be attempted when the stone is s'mall Females are not so subject to Stone in the bladder as males, and the passage being much shorter, moderate sized stones, and other substances, have been extracted therefrom, by merely gradually stretching the passage till it was large enough to allow the introduction of a pair of forceps.

Treatment

With the view of preventing the further increase of the stone, the use of both acids and alkalies, according to the nature of the gravel or stone, may be tried. When that consists of Uric Acid, which may be known by the red deposit in the urine, the patient may take the following:-

Solution of Potash................................Four Drams.

Compound Tincture of Cardamoms,........Four Drams.

Tincture ofHenbane.............................Four Drams.

Syrup................................................Four Drams.

A teaspoonful to be taken three times a day, in a glass of water.

Magnesia has been found of much service in neutralizing Uric and Lithic Acids, but we must be careful to stop in time, or the Gravel may be changed from the acid to the alkaline descriptions. The Bi-carbonate of Soda may be substituted for the Solution of Potash, if the patient prefers it. If the Gravel is ascertained, (according to the instructions given above) to belong to the fusible or phosphate description of Gravel, the patient may take the following:-

Muriatic Acid..................................Two Drams.

Tincture of Orange Peel.....................Half an Ounce.

Syrup............................................Half an Ounce.

Water sufficient to make Two Ounces.

Take a teaspoonful three times a day, in half a wineglassful of water. The dose may be gradually increased to two teaspoonfuls.

In severe fits of the Gravel, when the attack is acute, the patient should be put in a hot bath; after which he may take a gentle purgative, (one of those recommended in this work), and he may take,

Tincture of Digitalis............................Two Drams.

Tincture of Hyoscyamus.......................Two Drams.

Water sufficient to make Two Ounces.

A teaspoonful every three hours.

Or, he may take ten grains of Bromide of Potash, every four hours.

He may drink plentifully of thin Oatmeal gruel or Barley water; and the hot bath may be repeated in a few hours, if necessary.

During the paroxysms of pain occasioned by a stone, considerable relief has been experienced from injecting a small quantity-say, two or three ounces-of milk-warm water into the bladder; but it is in cases of irritation and inflammation at the neck of the bladder, hat this injection is of most service.

In the greater number of cases of Gravel, the quantity of Uric-Acid formed is so great that, however abundant the urine may naturally be, it is not sufficient to hold the acid in solution. We ought therefore to endeavour to increase the quantity of urine by drinking plentifully of such liquids as will have that effect. Soda Water and Dandelion Tea will be found useful for that purpose.