'o60 PHILOSOPHICAL TRANSACTIONS. [aNNO IGQQ. 



and through ; and besides, tlie place where he makes the incision, being full 

 of considerable vessels, one can hardly avoid cutting some of them. He suc- 

 ceeds better when the stone is large than when it is small, because a large stone 

 not only extends the bladder, but stops the point of the knife. When there is 

 but a small stone, the bladder being empty, he must necessarily cut it through- 

 out, and consequently some of its own vessels, which causes the hasmorrhage, 

 and is the better avoided when the stone is very large. 



Now, for my own opinion, though I cannot approve that way on all occa- 

 sions. I took a body, in the bladder of which I put a stone, the staff being 

 in the bladder, I pressed it downward, hard enough to be felt through the tegu- 

 ments, and made the incision upon it in the bent of the thigh, in order to 

 know whether it would not be a surer way by securing the point of the knife ; 

 by that way I got the conductor and forceps into the bladder, and drew the 

 stone very easily ; but afterwards, by the dissection of the body, I found that 

 the artery of the penis, and the vesiculae seminales were cut through and through, 

 which cannot be avoided, because the artery and vesiculae lie immediately under 

 that part of the bladder which the staff presses upon. 



I took another body, and having put in the bladder a small stone, I made 

 the incision tnuch lower, and pierced the bladder under the staff, by which 

 incision I drew the stone. Then dissecting the body, I found the bladder cut 

 through, and its arteries, which can hardly be avoided, the bladder being then 

 so much contracted, that both sides are cut, before the operator either feels the 

 stone, or sees any urine running out. 



I took a third body, in the bladder of which I put up a very large stone, the 

 staff being in it, I made the incision upon the fat protuberance, under the 

 ischium ; and piercing the bladder below the staff, I found immediately the 

 stone with the point of the knife, with which I cut the bladder, the length of 

 an inch ; through which having introduced the conductor, and then the forceps, 

 I got hold of the stone and drew it out very easily. After dissecting the body 

 I found that neither the vesiculas seminales nor any artery had been cut, because 

 the weight of the stone pressed the bottom of the bladder lower than the vesi- 

 culae and arteries. 



My opinion then is, that this method might be made use of when the stone 

 is very large, and I would prefer it to the old way ; for by this way we avoid 

 that extraordinary and violent dilatation of the neck of the bladder, which the 

 stone causes when large, and which is the cause of the inflammation and morti- 

 fication of the bladder which kill the patient. But when the stone is small, or 

 of but a moderate size, the old way is easier and surer. 



Though I have not tried this way on women, yet I c;innot approve it at all. 



