. Les maladies du rectum et anus : conçu pour les étudiants et les praticiens de la médecine. N'importe quel légume aliment ayant de longues et des fibres, ifeaten en grandes quantités, peut entraîner la formation de concrétion de anintestinal ce type. Calculs intestinaux (bézoards). - Concrétions pierreuses otherthan calculs biliaires ont été rencontrés dans toutes les parties de l'en-testine, mais moins souvent (voir le Dr cas Fullers. Fig. 209). 638 LES MALADIES DU RECTUM ET ANUS Bézoards sont rarement réunies dans le cadre de quarante, et se produire dans morefrequently les femmes que les hommes. Elles peuvent être petites et ir-de forme régulière ou grande et

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. Diseases of the rectum and anus: designed for students and practitioners of medicine. Any vegetable food having long and coarse fibers, ifeaten in large quantities, may result in the formation of anintestinal concretion of this type. Enteroliths (Intestinal Calculi). — Stony concretions otherthan gall-stones have been encountered in all parts of the in-testine, but less frequently (see Dr. Fullers case. Fig. 209). 638 DISEASES OF THE RECTUM AND ANUS Enteroliths are rarely met with under forty, and occur morefrequently in women than men. They may be small and ir-regular in shape or large and oval, and vary in weight from afew grains to 15 ounces (456 grams). When multiple they oc-casionally weigh even more. Niemeyer has recorded a casewhere 32 stones were evacuated, weighing, in all, 2 Y2 pounds(1300 grams). Enteroliths are located in the colon and rectummore frequently than in the small intestine. Composition. — The make-up of intestinal calculi differsslightly. Most of them, however, are composed principally ofthe phosphates of lime, magnesia, ammonia, and organic. Fig. 210.—Urinary Calculus, Weighing more than Four Ounces, which Pro-jected into the Rectum, Causing Stricture and Recto-vesical Fistula.(Authors Case.) matter. They are not uncommon in persons who have takenfor a considerable time large doses of mineral remedies, suchas bismuth, chalk, benzoin, and lime. The author has on threeoccasions removed through a colostomy opening enormous, black, putty-like masses, composed of bismuth; in each caselarge doses of this drug had been given daily for the relief of acolitis and frequent stools, where the irritation causing thewatery evacuations was induced by a mechanic obstruction ofthe rectum due to carcinoma. Pancreatic Calculi.—These concretions are rarely found inthe intestine, and when present are so small that they do not ENTEROLITHS AND CONCRETIONS 639 produce any disturbance beyond a slight irritation. They maybe single or multiple, smooth and rou

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