88 PHILOSOPHICAL TRANSACTIONS, [aNNO 1 696. 



tended with the danger and difficulty which are dreaded on the extraction of a 

 stone out of the bladder, and that there was no prospect of relief by any other 

 method, he determined to submit to the operation. 



The patient had not long recovered from under Mr. HoIIier's care, before he 

 began to complain of pain, which resembled his old pain of the stone, and 

 this continued upon him for 4 or 5 years before he was sensible of any fulness 

 or swelling in perinaco. Probably Mr. HoUier left either a couple of little 

 stones or pieces of stone at the time of extraction, which were by degrees 

 protruded into the urethra ; but being too large to be voided, lodged themselves 

 there, and so by perpetual accretion arrived to their present magnitude. He 

 constantly comjilained of pain in making water, which usually came away by 

 drops, and involuntarily for several years past. Nor was he longer at ease than 

 while his bladder was full and distended with urine ; which distension was con- 

 tinued all along the neck, and the urethra, as far as where the stones were 

 bedded : for his only way of procuring himself ease was by frequent drinking 

 large quantities of small beer or water; and as soon as the separation could be 

 made lA' the urine into the bladder, and while that continued full, he was sen- 

 sible of some ease. He has been likewise exceedingly liable to vomiting of 

 late, and generally molested with a diarrhoea for some years past ; both v\hich 

 had lately so increased upon him, as very much to have impaired his health, and 

 weakened his constitution. 



Having prepared him with such evacuations as are proper to precede such an 

 operation, on Monday the 28th of September last, I performed it, by cutting 

 upon the most protuberant part of the stones, and making my incision pretty 

 large, the upper part, which proved a distinct stone, and had formed itself a 

 socket in the lowermost, slipped out with little or no difficulty ; the other, 

 which was forked, and was as it were bound in, as if it had adhered to the 

 urethra, was removed with more trouble, and broke in the taking out, being 

 neither of them very hard. There was not an ounce of blood lost in the ope- 

 ration ; the stones, having lodged long there, had made a very great distention of 

 the urethra, so that it was become so callous, that I seemed to cut through a 

 cartilage. The stones being thus taken out, the wound was dressed, and con- 

 tinues in a very good condition, I had almost forgot to tell you, that to faci- 

 litate my removal of that stone which was locked in, I put two of my fingers 

 up the anus, to secure it from retiring towards his bladder, and to my surprise 

 I found that one of the angles of it had perforated into the anus. 



The Jigure and position of the stones, fig. 13, pi. 1. — A the point which 

 tended towards the glands : B that part which lay in the acetabulum ; c the part 

 upon v\hich the incision was made; d the ticetabulum ; e the point which lay 

 towards the neck of the bladder ; f that which had perforated into the anus. 



