S58 PHILOSOPHICAL TRANSACTIONS. [aNNO 1742. 



About the beginning of January last, lie was attacked with a severe fit of 

 the stone, attended, on every attempt to make water, with a strong tenesmus, 

 that forced into the scrotum a considerable quantity of the intestines, which 

 exceeded his skill to reduce. Mr. B. found the tumour large and unequal, but 

 without much tension or inflammation; his pulse low, with clammy sweats; he 

 complained of violent pains in his back, propagated through the whole length 

 of the ureters, accompanied with nausea and vomitings; he felt exquisite pain 

 about the neck of his bladder and glans, with an unusual weight inperinaeo; 

 he had frequent inclinations to make water, but seldom made above a spoonful 

 at once, and that drop by drop, with much pain, and sudden stoppings; the 

 urine was extremely fetid, sometimes mixed with purulent matter, at others 

 tinged of a coffee colour. 



He had received, just before, a clyster, which produced 2 stools, and encou- 

 raged him to hope might facilitate the reduction of the rupture. He attempted 

 it by all necessary means possible, but without success; for though the largest 

 part receded and gave way, yet a considerable portion remained, which he could 

 not possibly return. He therefore concluded, as the intestines performed their 

 office, and were free from tension, inflammation, &c. that the parts adhered: 

 so left him, with directions for a bag-truss to support them. 



January the 22d, being informed of his death, he applied for leave to open 

 him, which was granted. In examining the contents of the abdomen, he found 

 the left kidney quite wasted, scarcely any thing remaining except the coats, 

 and those filled with blood and purulent matter; the ureter very much enlarged 

 above its natural capacity, and full of the same. The right kidney was ulce- 

 rated in several places, and full of purulent matter, mixed with grit; several 

 hydatids appeared on its external surface, the ureter was somewhat enlarged. 



He next examined the bladder, which was exceedingly large, and contained 

 above 3 pints of clear urine: on opening it, and introducing his hand he found 

 2 smooth flattish stones, somewhat larger than common Windsor beans; he 

 discovered a third in the neck of the bladder, which probably had been forced 

 there during the paroxysm, and appeared to be the immediate cause of his 

 death ; it was about the size of a filbert, and had quite blocked up the passage. 



On dissecting the hernial bag, the first part that presented was a large piece 

 of fat, about -i- lb. and immediately underneath it lay a large portion of the 

 colon, about 10 inches in length: the internal surface of the peritoneum was 

 strongly attached to the colon by several filaments, and to the scrotum by its 

 cellular substance. All the other viscera were in a natural state. 



