[ 4i3 ] 
plement to the other Methods for all Cafes that 
offer. 
Thus much I have learned by Experience, that is, 
by the ill Succefs of the different Methods of Cut- 
ting by the low Apparatus in the Cafe of large Stones : 
And therefore I am refolved to follow the high Ope- 
ration in the faid Cafe. 
In adopting this Way of Cutting, as pra&ifcd by 
Mr. 'Douglas, Chefelden , and Morand, I thought I 
might, under the Patronage of thefe great Men, be 
able to make fome Improvements on it. 
An Inconvenience, which always happened In do- 
ing this Operation, is, that as foon as the Knife has 
open’d the Bladder, the Urine or Liquor injected, 
which kept up its Side clofe to the Integuments, 
comes off; the Bladder finks, and often flips from 
the Inftrument before the Indfion is made large 
enough j and then it is very difficult to find the 
Bladder, and finifh the Operation, which by this 
means becomes tedious and painful. This Accident 
has happened feveral times. 
In order to guard againft it, I have thought of two 
Things : 
Firft, Inftead of cutting the Bladder downward, 
which contributes to the finking-in of its Coats, I 
plunge the Knife into the Bladder behind the Os 
'Pubis, and I cut it upward toward the Belly ; by 
which means the Edge raifes and fupports the Coats 
of the Bottom of the Bladder. When I fee that my 
Incifion is large enough, I turn my Inftrument quick, 
fo that the Back may be where the Edge was : And 
this Back has a very fmooth Shoulder, as appears in 
TAB, IV. Fig. 7. This Shoulder continues to keep 
Ggg ’the 
