3 ° 9 
from the human Bladder . 
lay on the neck of the bladder, by the operation. The internal 
structure was thus exposed, in which appeared distinct stones 
or nuclei, now consolidated into one mass, disposed in layers. 
The weight of the stone was forty-four ounces, or three 
pounds four ounces (apothecary’s weight), the form of it 
elliptical, the periphery, on the longer axis, sixteen inches, on 
the shorter fourteen. 
The kidneys were altered considerably in their texture, and 
their pelvis much enlarged, the left was pressed up higher 
than natural, and adhered firmly to the spleen. The right 
was attached to the ascending colon, and general adhesion 
had obtained between all the surrounding parts. The ureters 
were much increased in their dimensions and thickness, and 
were capable of containing a considerable quantity of fluid ; 
they were in fact supplemental bladders, the real bladder 
having become nothing more than a painful and difficult con- 
ductor of urine, which trickled down in furrows formed by it 
on the superior surface of the stone. This clearly explained 
the cause which obliged the patient, when compelled to eva- 
cuate urine, to put himself in that posture which made the 
upper part of the bladder become the lower, by which means 
a relaxation or separation was allowed to take place between 
the bladder and the stone, so that the ureters had an oppor- 
tunity of discharging their contents ; when the body was erect, 
their mouths, or valvular openings, must of course have been 
closed, by the pressure of the abdominal viscera on the bladder 
against the stone. 
His difficulty of voiding urine, appears to have gradually 
increased as the bladder became more and more filled with the 
stony matter, and the extremity of his distress did not come 
MDCCCIX. S S 
