f large calculi are offered: by Holmes, 25 ounces;
Hunter, 25 ounces; Cayley, 29 ounces; Humphrys, 33 ounces; Eve, 44
ounces; and Janeway, 51 ounces. Kirby has collected reports ol a number
of large vesical calculi.

Barton speaks of stone in the bladder in very young children. There is
a record of a stone at one month, and another at three years. Todd
describes a stone in the bladder of a child of sixteen months. May
removed an enormous stone from a young girl, which had its nucleus in a
brass penholder over three inches long.

Multiple Vesical Calculi.--Usually the bladder contains a single
calculus, but in a few instances a large number of stones have been
found to coexist. According to Ashhurst, the most remarkable case on
record is that of the aged Chief Justice Marshal, from whose bladder
Dr. Physick of Philadelphia is said to have successfully removed by
lateral lithotomy more than 1000 calculi. Macgregor mentions a case in
which 520 small calculi coexisted with a large one weighing 51 ounces.
There is an old record of 32 stones having been removed from a man of
eighty-one, a native of Dantzic, 16 of which were as large as a
pigeon's egg. Kelly speaks of 228 calculi in the bladder of a man of
seventy-three, 12 being removed before death. The largest weighed 111
grains. Goodrich took 96 small stones from the bladder of a lad. Among
the older records of numerous calculi Burnett mentions 70; Desault,
over 200; the Ephemerides, 120; Weickman, over 100; Fabricius Hildanus,
2000 in two years; and there is a remarkable case of 10,000 in all
issuing from a young girl. Greenhow mentions 60 stones removed from the
bladder. An older issue of The Lancet contains an account of lithotrity
performed on the same patient 48 times.

Occasionally the calculi are discharged spontaneously. Trioen mentions
the issue of a calculus through a perineal aperture, and there are many
similar cases on record. There is an old record of a stone weighing
five ounces being passed by the penis. Schenck mentions a calculus
perforating the bladder and lodging in the groin. Simmons reports a
case in which a calculus passed through a fistulous sore in the loins
without any concomitant passage of urine through the same passage.
Vosberg mentions a calculus in a patent urachus; and calculi have
occasionally been known to pass from the umbilicus. Gourges mentions
the spontaneous excretion of a five-ounce calculus; and Thompson speaks
of the discharg