VOL. XXI.] PHILOSOPHICAL TRANSACTIONS. 359 



felt it, he runs his incision knife at the bending of the left thigh, upon the fat 

 protuberance below the ischium bone, directly upward by the rectum to the 

 bladder, which he pierces by its neck, and sometimes a little above it. 



When he cuts, the cutting parts of his knife are turned upward and down- 

 ward: having thus pierced the bladder, which he knows by the urine running 

 out, he turns his knife, and thrusts it a little further, in order to open the 

 bladder wide enough that his finger may go in easily; then he withdraws his 

 knife, and enlarges the wound in the outward parts, of the length of 2 or 3 

 inches; after which he thrusts his finger into the bladder, in order to know 

 more precisely the size and situation of the stone, and make it loose, but 

 chiefly to dilate the opening into the bladder, by tearing its membranes. Then 

 he introduces his conductor into the bladder along this finger which is in it. 

 When the conductor is in the bladder, he takes the staff out, and introduces the 

 forceps by the conductor into it, with which he gets hold of the stone, and 

 draws it out. 



If he find any difficulty, either in getting hold of the stone or in drawing it 

 out, he employs all the usual means, raising the left thigh more or less, putting 

 his finger in the fundament, and sometimes into the bladder, in order to exa- 

 mine the situation of the stone, and loosen it, in case there might be any adhe- 

 sion with the membranes of the bladder. Having found out and removed the 

 cause of the difficulty, he thrusts the forceps again into the bladder, and gets 

 hold of the stone, and so draws it out. 



It is to be observed, that neither this second time, nor on any other, does 

 he use any conductor, the forceps running in very easily. He never thrusts 

 either his finger nor any instrument into the bladder without steeping them in 

 oil of roses. He never uses any dilatatorium, nor canula, or tents in the 

 wound, except sometimes small dossils in the lips of the outward wound, to 

 keep them open for a little while. He uses no ointment at all for the wound, 

 applying only a pledget steeped in oil of roses upon it. 



In this way he operates as dexterously as any of our best operators. He 

 often cuts the patient on the gripe, almost in the same manner as was used 

 formerly, except that he makes the incision in the same place as for the former. 

 This way he likes better than the other, and indeed it is surer, though the 

 pressing on the belly, which he uses, is a very bad method. 



He cuts women also on the staff, and in the same place as men ; only that he 

 cuts the internal neck of the urethra. 



But in my opinion, that method either in men or women, is not so sure as 

 the ancient plan, because the point of his knife not being directed by the staff, 

 he is always in danger of piercing all the membranes of the bladder through 



