Calculus of the bladder is endemic in parts of China. Thomson1 reported 2,949 lithotomies performed at the Canton Hospital between the years 1861 and 1919. Olpp and Kuhne,2 in the same province observed 189 cases of vesical calculus in nine years. Cochran3 in Anhwei Province, in Central China, treated 227 patients with calculus of the bladder in the course of twelve years. In five years I saw about 150 patients with vesical calculus at the University Hospital in Tsinan, capital of Shantung Province; 126 of these patients admitted for treatment form the basis of this report.
Shantung is a northern coastal province. The dense population, estimated at about 38,000,000, is largely rural, wresting a subsistence from the arid soil by means of a primitive system of irrigation. Although the winters are long, the total number of hours of sunshine during the year is large.
INCIDENCE
Three fourths