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In the examination of the several modes of treating urinary concretions, the question of their indications and contraindications is worthy of special attention, since adherence to a single procedure belongs to the medicine of a remote past. Modern medicine demands that preventive measures be taken in threatened calculous affection at the first sign of coming of hyperlithæmia; that when hyperlithuria exists, medicinal treatment be resorted to; that when calculi are formed, mechanical means be promptly applied for their removal; that when the calculi have been removed, the cure be accomplished by suitable after-treatment; and that when mechanical treatment is contraindicated, a judicious course of palliative treatment be adopted. Therefore the treatment of urinary concretions is now arranged into the preventive, medicinal, palliative, mechanical and post-mechanical treatment.
The preventive treatment embraces hygienic, medicinal and mechanical means. The needed hygienic observances comprise diet, exercise, ablutions and raiment. The medicinal means of prevention
GOULEY JWS. ABSTRACT OF A PAPER ON THE CHOICE OF TREATMENT OF URINARY CONCRETIONS. JAMA. 1889;XIII(9):289–295. doi:10.1001/jama.1889.04440050001001
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