192 ~ PHILOSOPHICAL TRANSACTIONS. [aNNO I746. 



A remarkable Case of a Person cut for the Stone in the New JVay, commonly 

 called Lateral. By Ifilliam Cheselden, Esq. N° 478, p. 33. 



Mr. Simpson, aged 75, after having been afflicted with the stone above 5 

 years, and taking Mrs. Stevens's medicines about a year before for 7 months suc- 

 cessively, without receiving any benefit, was cut by Mr. Cheselden, March 13, 

 1741-2, at which time he had a fit of the stone on him, which had continued 

 for 10 days; and when consequently the bladder and urinary parts were very 

 much inflamed; which, together with his great age, made the success very 

 doubtful. However, at his own earnest request, after consultation, the operation 

 was performed, and a large flattish round stone was extracted, weighing very 

 near 4 oz. 



The wound bleeding plentifully from the small vessels, only a piece of thin wet 

 sponge was introduced, that it might bleed for a while through; intending, if 

 there should be occasion, to tie any vessel afterward, that should require it. But 

 contrary to expectation, this proved the means of stopping the efRision of blood ; 

 and from experience, in many cases since, it has been observed that nothing is 

 so useful as this method, thus accidently discovered. About 6 hours after the 

 operation, the patient having lost but little blood, it was thought proper to take 

 12 oz. of blood from his arm. The urine flowed freely through the wound in 

 about 2 hours after his being cut, and also through the penis; and continued to 

 do so, though with great pain from the heat and sharpness of it ; which excoriated 

 the parts about, notwithstanding his being dressed every 2 or 3 hours, and the 

 parts being anointed with a cooling ointment. 



On the 4th day, not haying had a stool since the operation, an emollient clyster 

 was ordered; which purged him twice, gave him a great deal of ease, and abated 

 some slight feverish symptoms that were observed. This was repeated once in a 

 day or 2 for about 3 weeks, he being naturally costive. 



About a week after the operation he complained of a pain in his sides, and had 

 little convulsive motions in his bowels, with faintings, and the abdomen swelled : 

 but, on bleeding him 8 oz. his pain was removed, and the other symptoms went 

 off on taking the confect. raleigh. in aq. paeon, comp. every night for a week. 



During this time the wound began to digest, a large slough cast off, and in it 

 came away several very small bits of stone, which had crumbled off in extracting 

 the stone with the forceps. These, by obstructing the free passage of the urine, 

 had given him sometimes great pain, but which was removed by frequently in- 

 jecting oil and warm barley-water through the penis and wound. 



At the beginning they made use of a fomentation made of absinth, roman. et 

 flor. chamaemael. but it proving too sharp for the excoriated parts, it was left off, 

 and the parts bathed with warm milk, and sometimes barley-water. His diet, the 



