304 Sir James Earle’s Account of a Calculus 
became unable to make water in an erect position ; this incon- 
venience increased to such a degree, that latterly he could 
make none without standing almost on his head, so as to cause 
the upper part of the bladder to become the lower, and this 
he was obliged to do frequently, sometimes every ten minutes, 
as the quantity at each time was less than the measure of a 
wine glass ; and when he used exercise, it was tinged with 
blood. 
The principal remedies which had been prescribed for him 
were aqua calcis and uva ursi ; but he never persisted long in 
the use of either. At times, when the pain was violent, he 
had recourse to opium by the mouth and per anum : this, added 
to a naturally costive habit of body, rendered necessary the 
frequent assistance of aperients. 
At the age of fifty-three, thirty years after the accident, the 
spasms and fits of pain, from the urgent desire to void urine, 
became so frequent and violent, and his life so completely 
miserable, that he was determined to have the stone extracted. 
I received a letter, requesting my opinion whether a paralytic 
state of the lower limbs was a prohibition to the operation of 
lithotomy ; on my reply to the contrary, he was put on board 
a ship and conveyed to the Thames, brought in a boat to 
Hungerford Stairs, and in an easy carriage to Hanover-street, 
without suffering any inconvenience of material consequence. 
Toward the latter end of July, 1808 , 1 visited him, when he 
gave me a clear and distinct account of what has been related, 
and added, that the stone could be evidently felt above the os 
pubis. At first, I much doubted of the large prominent tumor 
which I saw in the lower part of the belly, being a stone, but 
on attempting to pass the sound, it would not enter the bladder. 
