[ ?°9 ] 
much feverity. About ten years after the firft 
appearance of thefe complaints, a fwelling came 
on in the left lumbar region, which, after having 
been very painful, for a confiderable time, fuppu- 
rated. This wound, which very foon became fiftu- 
lous, has continued open ever fince, and has con- 
ftantly afforded an ichorous difcharge. It was not 
till December 1772, fifteen years from the appear- 
ance of the tumour, that this difcharge began to 
abate, and that the wound, from being perfectly 
eafy, became painful and inflamed. During all this 
time the nephritic fymptoms had continued to 
return, without any variation, the urine had con- 
ftantly afforded a gravelly fediment, and feveral 
fmall ftones had paffed through the meatus url - 
narius ; but thefe concretions were now about to 
take a different courfe. The pain in the back, 
which had commonly affedted the left fide, be- 
came much more intenfe than ufual, but was not 
attended by any of the other fymptoms, which had 
been the ufual forerunners of a fit of the gravel. 
The difcharge, from the wound, was fuddenly di- 
minifhed, and the pain and inflammation exceed- 
ingly increafed, though the urine continued to 
pafs in a healthy quantity, and without difficulty. 
Thefe complaints continued, during eight days, 
and then a round and fmooth calculus , weighing 
about twelve grains, was extracted, with fome diffi- 
culty, from the wound. Since that time no gravel 
has been voided with the urine, though no urine 
ever paffes through the wound j and fix other 
paroxyfms, like that 1 have defcribed, have taken 
place, in which the fame fymptoms have occurred, 
and 
