Papillary Pathology as a Precursor of Primary Renal Calculus

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Abstract
Primary renal calculus is only a symptom, and always originates as a slow crystallization of urinary salts upon a lesion of the renal papilla. Evidence is presented as proof that Ca phosphate, Ca oxalate and uric acid crystallization, to form renal calculi, has in each instance taken place upon a plaque of Ca salts deposited in the renal papilla. Papillary pathology is believed to precede the development of a primary renal calculus and to act as the initiating lesion upon which these urinary salts crystallize. Those calculi, supposed to be associated with hyperparathyroidism, hypovitaminosis, odd forms of renal infection and cases of nephrocalcinosis, etc., belong to a separate and different form of papillary pathology associated with tubular inspissation of salts (Ca infarction) and represent the end results of hyperexcretory states.

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