Ninety seven examples of urinary calculi, fifty eight of which are kidney stones, were studied by microscopical and X-ray methods. About one hundred and twenty thin slices were prepared for this purpose, and examined by the polarization (petrographic) microscope.
These calculi are grouped as follows:
1) Oxalate calculi (54): Consist of CaC
2O
4⋅2H
2O, CaC
2O
4H
2O and apatite, sometimes lacking in CaC
2O
4⋅2H
2O.
2) Struvite calculi (2): Contains brushite and apatite, one of these contain oxalates.
3) Struvite calculi (27): Contains struvite (MgNH
4PO
4⋅6H
2O) and apatite, frequently accompanied with oxalates.
4) Uric acid calculi (12): Contains uric acid, many of these also contain oxalates.
5) Cystine calculus (1): Mainly cystine.
6) Unknown calculus (1): Mainly an unidentified substance. This is not found in the literatures hither to known.
A substance, forming minute fibres and frequently spherolites, is assumed to be newberyite (MgHPO
4⋅3H
2O). Seven calculi contain this substance as a minor component.
Because of its optically isotropic character and of its massive form, it is scarcely possible to identify apatite from other truely amorphous and amorphous-like substances.
These amorphous and amorphous-like substances (mainly apatite) are found in all calculi and the first products of many calculi are these.
Frequently weddellite (CaC
2O
4⋅2H
2O) was crystallized in the already formed part of the amorphous substances, cutting the hands of them.
Whewellite (CaC
2O
4⋅H
2O) crystals are divided into three types. Granular whewellite is the secondary product after weddellite, fine-grained comes after apatite, and radial is primary one crystallized directly from urine.
The term of whewellitization is proposed for explanation on the relation between weddellite and whewellite, and the crystallization course of whewellite.
The first stage of whewellitization is the change from CaC
2O
4⋅2H
2O to CaC
2O
4⋅H
2O, and followed by further growth of pseudomorphous whewellite or crystallization of radial whewellite.
The structures of the main components and their crystallization velocity are as follows.
1) Apatite: massive (slow).
2) Whewellite (CaC
2O
4⋅H
2O): granular (pseudomorph after weddellite), fine-grained (from apatite), radial (rapid).
3) Weddellite (CaC
2O
4⋅2H
2O): disordered in apatite (rather slow), dentritic (rather rapid).
4) Brushite (CaHPO
4⋅2H
2O): rudely radial (rather rapid).
5) Struvite (MgNH
4PO
4⋅6H
2O): beehive-shaped (slow), zonal alternation with apatite (rather rapid), sutured (rapid).
6) Uric acid: granular (rather slow), radial (rapid).
7) Cystine: radial (rapid).
8) An unidentified substance: radial (rather rapid).
From the paragenetical relations, the crystallization conditions of components are assumed as follows.
1) Acidic condition-Uric acid.
2) Ordinary condition-Apatite and weddellite.
3) Ordinary but pathological condition-Whewellite.
4) Alkaline condition-Struvite.
No minute crystal as kernel of a calculus is not found in any slice. As kernels most calculi contain massive apatites and other amorphous substances, with relatively large sizes, and it is notable that an oxalate calculus or its fragment frequently forms the secondary kernel of a calculus of other kind.
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