The Medical Management of Urinary Lithiasis
In certain countries, the incidence of urinary calculi varies considerably. In Great Britain “stone areas” are well recognized; urinary calculi occur more frequently along the east coast, and in parts of Derbyshire and in North Wales. Joly1 stated that in the east and southeast of France, kidney and bladder stones are prevalent but are found infrequently in Normandy. In Africa, urinary calculi frequently occur in the region of the lower but not of the upper part of Egypt. The relationship of bilharziasis to the frequency of calculi and the variation in the two regions was investigated by Pfister2 who stated that the ova formed the nucleus for stones in approximately 10 per cent of the cases. Holmes and Coplan3 made an intensive study as to the prevalence of urinary calculi in the various sections of this country. From personal communications with urologists throughout the United States, they concluded that calculi occurred more frequently in southern Florida and in southern California than in other parts of the country.
In 1931 McCarrison4 stated that in some regions in India, stones were so prevalent among the populace that these places were designated as “stone areas,” while in other localities, they were encountered but rarely. McCarrison observed the frequent occurrence of stones in regions in which there was not proper balance of food constituents in the diet.
Fujimaki5, under the supervision of Dr. Saiki, while investigating the vitamin content of food materials, observed the frequency of the occurrence of bladder and renal calculi in. . .