25*2 PHILOSOPHICAL TRANSACTIONS. [aNNO 174G. 



Oil ExlTctcling a large Stone by an Aperture in the Urethra. By Mr. George 

 Howell, Surgeon, at Haverfordivest. N° 480^ p. 215. 



John Cod, of Rocli, in Pembrokeshire, aged 40, was -from his infancy troubled 

 with nephritic complaints, and frequent obstructions of urine. He, at 25 years 

 of age, had a total suppression of urine for some days ; when, on a stone rushing 

 out of the bladder into the urethra, he had immediate ease from his pain ; and 

 was therefore negligent concerning its extraction from thence. 



Five years after, he married; the stone remaining in the urethra; which was 

 then, he imagines, about the size of a walnut. In 4 years his wife brought him 

 1 children. About that time he sent for Mr. H. and wanted him to dissolve the 

 stone; behaving just then read some treatises speaking largely of the powers of 

 lithontriptic medicines. He told him, that admitting the power of the dissolvents 

 of the stone might be very considerable, when the stone was in the bladder, and 

 might be surrounded by the medicated urine, very little was to be expected in the 

 posture the stone then lay ; but if he was willing to have it cut out, he would 

 undertiike the operation. This he would by no means consent to ; and so they 

 parted at that time. He heard no more from him for Q years. 



In August last he had a message from his family, desiring his assistance, be- 

 lieving him dying; he having had a total suppression of urine for 3 or 4 days. 

 Just as the servant was coming with the message, his urine had forced a passage 

 through the superior part, or dorsum penis, and had flowed out plentifully. 



On coming to him, Mr. H. proposed cutting out the stone ; his answer was, 

 he would submit to whatever he should think necessary ; he being now convinced, 

 that if he were not speedily relieved, his death would be inevitable. 



The whole quantity of urine, contained in the bladder, had made its way 

 through the new opening in the back of the penis ; and therefore at present the 

 inflammation of the penis being very violent, he deferred the operation, and only 

 applied a fomentation and cataplasm, to take off that inflammation. 



He returned in 2 days ; and, by an incision into the urethra near 3 inches long, 

 he extracted the stone, which had been there 15 years. It weighed 2i oz. and 

 measured 6 inches round, in the direction it lay in the penis. About 50 small 

 stones lay between this great one and the bulb of the urethra. These came forth 

 from this incision. After this, he put in 5 pins, and made the twisted suture, and 

 then introduced a leaden canula. 



The urine passed regularly 2 days ; when an inflammation came on, which tore 

 out all the stitches. He tried once more, and took the greatest hold possible ; 

 but the urethra was so tender, that all endeavours to unite the lips of the wound 

 were fruitless. The man was glad to compound for life, even with the loss of the 

 penis, if that were necessary, which the stone had increased to an enormous bulk. 

 But, after attending and dressing him about 2 months, the orifice, through which 



