The symptoms in calculous nephritis and ureteritis are seldom commensurate with the gravity of the case, or the size of the calculus. Small calculi are the most dangerous as they threaten the functional life of the kidney, before giving rise to symptoms that suggest their presence. A calculus resting in the calyx or pelvis of the kidney is simply a foreign body. So long as it remains aseptic it can only produce mechanical irritation or obstruction. Such a quiescent aseptic calculus can increase to large proportions before it is suspected.
A number of large calculi that have been found produced only a dull ache in the lumbar region, a slight amount of albumin, and in some a microscopic trace of pus. In some of these cases the condition had lasted for years and had been frequently diagnosed as chronic Bright's disease. The semi-quiescent calculi produce more marked symptoms. They are
LEONARD CL. THE SYMPTOMATOLOGY OF CALCULOUS RENAL AND URETERAL DISEASE.. JAMA. 1902;XXXIX(16):952-955. doi:10.1001/jama.1902.52480420004001a