514 PHILOSOPHICAL TRANS ACTIOJSTS. [aNNO 1681, 



(168I) the catheter was io^oduced, but no water could then be drawn off; yet 

 shortly after, to the astonishment of all, the patient voided (with the sufferings 

 of a woman in labour) 8 pints of feculent greenish urine, but without any 

 calculus. After this she vomited up (instead of discharging by its natural pas- 

 sage) 3 or 4 oz. of strong smelling urine every 2nd or 3d day, until the l6th 

 of May; since which time, by the help of baths and the copious use of water 

 mixed with spirits of nitre, she this summer is so far recovered as to have a 

 healthy appearance, and be able to walk about, having a tolerable appetite, and 

 making every day from 3 to 5 oz. of clear yellowish water, which deposits 

 some sediment, and is at times slimy and bloody. She has stools but scanty 

 and hard every 4th day, and she now and then vomits up some calculi, but in 

 much smaller quantity than before; on the other hand, sharp-pointed stones 

 are at this time more frequently discharged from the bladder. The belly is still 

 somewhat tumid, with a painful hardness in the left hypochondrium and in the 

 right lumbar region, and when handled produces a sound like that of stones 

 rubbing one against another. 



The sudden production of these calculi is, the author remarks, truly surpris- 

 ing. He thinks that if all the calculi which the patient voided at different 

 times had been saved and put together, they would have weighed 5ib« He 

 found some of them to crumble into powder on exposure to the air, and on 

 the contrary to become harder when put into spirit of wine, or any other liquor, 

 except an acid. He asks what could be the cause of the vesicular eruption ? 

 What the nature of that mucus which was contained in the bladder? How the 

 clysters could pass from one extremity of the intestinal canal to the other (ab 

 ano ad oesophagum) and be brought away by vomiting, while the colon and 

 rectum were obstructed with indurated faeces ? What could be the cause of the 

 green and blue colours of the urine? Why, when the catheter was introduced, 

 no urine could be drawn off; and yet soon after by an effort of nature, an 

 amazing quantity was spontaneously evacuated; after which there was again a 

 suppression of it? In what way the urine could get to the stomach and be dis- 

 charged by vomiting? Lastly, how the patient could exist so long without meat 

 or drink ? * 



* This is altogether one of the most extraordinary cases of calculous affection upon record. It 

 cannot be doubted that the calculi which were discharged by the mouth and anus were for the most 

 part generated in the alimentary canal j for they appear to have differed in colour and quality from 

 biliary calculi ; neither did the seat of the pain correspond with the situation and direction of the 

 gall-duct J nor were there any symptoms of jaundice. While the lithic concretions were forming in 

 the alimentary canal, they were likewise produced in the bladder, and, as the symptoms strongly ma- 

 nifested, in the right kidney also, if not in both kidneys. Their sudden generation in so many 



