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ers are the breeders and intensifiers of the worst types of
physical disease."
Akt. Y. — Preputial Calculi. By J. G. Keek, M. D., Can- Order Cefaclor
ton, China. Cefaclor Generic
The cases of preputial calculi in the accompanying table
are specimens of a complaint comparatively rare in Western
countries. A paper, in a previous number of this Journal,
will have shown the comparative frequency of urinary calculus
in Southern China. Many cases of urethral calculus have
been met with, and some specimens are in my possession, in
which the diameters are one and one-fourth by one-half inch.
Coexistent with these, as to latitude and climate, is the form of
calculus now under consideration.
Phymosis is not an uncommon deformity among the
Chinese, and it is, of course, only in cases where this abnor-
mal condition existed that preputial calculi could form.
The cases included in the table were operated on in the
Medical Missionary ^Society's Hospital in Canton, and I need
but refer to tlie simplicity and entire freedom from danger of
the operation, required for the relief of these cases, to show how
utterly destitute of surgical skill the physicians of the oldest
nation on the earth are, and how much Cefaclor Cd need there is of giving
them the knowledge and appliances of western science and
art.
A reference to the table will show that in every case ex-
cept one Purchase Cefaclor Online the calculi were multiple. In two cases the number
exceeded one hundred ; in one there were forty, and in three
others there were between twenty and thirty. In one or two
cases the calculi were uniform in size and shape, but, in Buy Cheap Cefaclor most
284 PREPUTIAL CALCULI.
of those where they were numerous, there were Cefaclor Antibiotics a few large
and many small ones. Some had smooth, even surfaces, while
others were angular, with facets.
The most remarkable of the cases was 'No. 7, operated on
in 1862. The patient was thirty-eight years old. The pre-
puce was much thickened and enlarged, and the presence of
calculi was easily discovered by a probe. A crucial incision
was made in order to remove the Cefaclor Tablets stones, and the superfluous
thickened skin was removed by circumcision. The calculi
were two in number, and the weight one ounce and a quarter.
The diameters of one were one and five-eighth by one and one-
eighth inch. It had two concave facets, on opposite sides. Cefaclor Generation One
facet which received the second stone was smooth and pol-
ished. The concave Cefaclor Price facet on the other Purchase Cefaclor side was precisely like
the first, except that it was slightly roughened Cefaclor Ceclor by recent de-
posit. The second stone was one Cefaclor Monohydrate and a half inch in diameter,
and was Order Cefaclor Online almost a perfect double convex lens in shape. One
of its sides, where it rested on the other stone, was worn quite
smooth, and it had evidently been shifted from one side of the
first stone to the other, thus maintaining the completeness of
the two concave facets. The calculi from case ISTo. 2 are in
the possession of Prof. S. D. Gross, of Jefferson Medical Cefaclor 500mg Col-
lege, Philadelphia.
I will add Cefaclor 250mg an account of two more cases, not included in
the table, because neither of them is strictly either preputial,
urethral, or urinary calculus :
Yip Akwong, aged twenty-one, was admitted into the Medi-
cal Missionary Society's Hospital, July 27, 1867 (then in charge
of F. Wong, M. D.), with an accumulation of calculi, in a sac
half the size of a Cefaclor Antibiotic walnut, on the under side of the penis, about
its middle, and communicating by a small opening with the
urethra. It had existed since his childhood, but had given
rise to no difficulty in passing water until recently. The sac
was laid open by a free incision, and a large number of calculi
removed. They w^ere of various sizes, whitish, smooth, and
shining. Four of them were about the size of pigeons'-eggs,
with irregular surfaces and angles. Six were smaller, oval in
shape, Cefaclor Mg and angular. There were two hundred and eighty- one
small pieces, varying in size from that of a pea to a millet
seed. Total number, tv/o hundred and ninety-one.
PREPUTIAL CALCULI.
285
The other case is, strictly speaking, one of lithotomy, but
the stone was in an unusual situation :
A patient, aged fifty years, from Buy Cefaclor Online Hoi-ping District, was
admitted with strictm-e of long standing and urinary fistulas,
which he persistently asserted had existed only about one
year, but the appearance of the parts indicated a much longer
duration. On probing the Cefaclor Cost fistulas, a stone was discovered,
located on the right side of the contracted scrotum, near the
groin. The fistula was enlarged toward the perinaeum, and
the stone extracted. It weighed two and a half drachms, and
its diameters measured one and a half by three-quarters of an
inch. Its appearance indicated that it was composed of uric
acid.
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