An Account of Two Stones of Remarkable Shapes and Sizes, Which, for the Space of Six Years, Were Firmly Lodged in the Urethra of a Young Man, and at Length Successfully Cut out from

An Account of Two Stones of Remarkable Shapes and Sizes, Which, for the Space of SixYears, Were Firmly Lodged in the Urethra of a Young Man, and at Length Successfully Cutout from Thence. Addressed to the Royal Society, on Thursday December 13, 1759, at WhichMeeting the Stones Themselves, and a Drawing of the Stones, Were Presented to the Fellowsof the Society, by Joseph Warner, F. R. S. and Surgeon to Guy's HospitalAuthor(s): Joseph WarnerSource: Philosophical Transactions (1683-1775), Vol. 51 (1759 - 1760), pp. 304-308Published by: The Royal SocietyStable URL: http://www.jstor.org/stable/105380 .

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XXXI5I, v47 Hscoant of FJwo Stones of re- markalle Shapes and SizesX wSoich, for the Space of ̂ Six Eears, were snly loclged ir the {Jrethra of a3oo>eg Max, and af length Jfaccefsfglly cat out from thesce. >1ddreffed to the Royal Societ, on ThurSday Decem- ber I 3 I759) at mvbich Meeting the Saores themlelse3, and a lkafwing of the Stones, ere pre§¢ented to the Dellows of zhe Society, Zy JoSeph Warner, F. R. SJ and 5z4rgeon to Guy's Hofipitale

Read 13ec. 1 3.r m H E formation and confinement of 1759* itony concretions in the different

parts of the organs of urine, to wit, in the kidneys, ureters, bladder, and urcira, are difeafes, which are frequcntly obServed to happen to both Sexes of all ages and conItitutions: for thls reafon I am apprifed, that there are few inIlances can he given of fuch peculia rities attending theSe caSes, as may reafonably be eReprned worthy the attentioil of the curious. Btlt when mstters of fadc, however conlmon in themfelves, are fo qircumlEanced, as to afl:ume extraordi nary appearances, the uncommon phanomena accom- panying fuch fadrs, when capable of being pointed out, will,- I believe, be always confidered by the RO)Ja1 Society) as a fuicient apology for the freedom of the communication. Upon this pl-efumption, I have taken the liberty of laying before the Fellows of

this

[ 304 ]



[ 3°5 ] this Society the following ffiort account, and, at the fame time, of fubmitting to tlleir infpeEtion as mucll of the cafe, as the nature of ehe affair could ad- mit of being exllibited.

C A S E.

Thomas Bingham, a very healthy young man, ̂ o years old, came from Yarmouth to London, in Sep tember I 759, and put himfelf under my care, to be cured of a fselling, which he had in his urethra Upon queRio1ling the patientX I Bras informed by him, that he had little or no pain; that he had never perceived the leaft difficulty in voiding lliS urine, noR had he ever had the leaI} involuntary efflux of it : he had not at any time fuffered in the leaIt but from the bulk and weight of fomething that grew in his urinary ,aSage (urethra), which, llpOll exercife of late, proved troublefome to him. Upon infpedion, I diScovered a confiderable prominence betwixt the teRicles and anus. Upon feeling the part with my fingers, there appeared a very evident hardnefs and tumor.

By introdllcing a largeg fmooths and dudile, probe into the urethras it was evident there was a Rons or Rones lodged in that paflige. I advifed the clltting the tumor ollt, which was conlplied with; and in the fUllowing tnanner I proceeded to the performance of the operationb

The patiene being fupinely placed upon a lleady tableX of a convenient height, covered with a double blanket, and a pillow put under his fhoulders, I callfed his hands and feet to be tied together; and, by proper afl*lRants, he was held in the fame poAition as

Vo^*LI. Rr is



[ soo ] is done in the operation of cutting for the llone in the urilzary bladder. I thel- prc)ceeded to divide the urethra longitudinally by inciflon. The extent of the irlcif1on was from one end of the rwelling to tho othcr: tlle length and fize of the wound enabled me to take away the flcones without any violence or difficulty.

After the Rones were removed, I brought the lips of tlle wound together, and, with the twiRed future, I retained them in that fltuation. By this method, and by occafionally pailng a bougie of a proper fize snto the urethra, beyond the farther extent of the in- Cifi10N, the patient went happily on, till the cure of the wound was completed, which was effieEted in about three weeks; and there afterwards remained no incon_ venience at all to the patient in voiding or retaining his urlne.

N. B. As the identical calculi are prefented to the Fellows of the Royal Society for their inEpeEtion, fo that the exadc fJzes, {hapes, and external forma- tions, of thefe fl:ones may be feen; I think it quite unneceSary to give a written account of thefe particulars. However, as it may probably glve fome fatisfadtion to the curious to be informed of the fpe- cific gravities of there Rones, I have fubjoined thefe particulars to this memoir, and have like- wife, for the fame xeafon, cauSed an engraving of thefe ilones to be made) and added to this paper.

Weight



Pf;M4M.7Fr.Vo/K.Hl.TM.vE. p. 307.

wt9. z * lle sy. 2

. sJ

F--: .]

_

.

^.-



[ 3°7 ] Weight in air. | in water. | Spec. gravity

Large Itone 308 S | 92 8S | t43I SmallRone 4z 35 lo 4 | I.326 Both Itones 350 8 I02 9 1 I 41S

2,uare. Is it not probables that the generation of theSe Ilones might originally have begun in theXure- thra, as the patient did not ever remember to have had the leaR complaint in his loins, or in any part of his bladder ? Or is it more reaSonable to ippofe that the Itones were firA of all formed in the kidney or urinary bladder, from tl}ence conveyed with the Itream of urine, when very fmall, and lodged in the urethra, till they had arrived to thefe fizes ?

Either of thefe fuppofltions to me appears reafon- able.

However, as hypothefes of this kind are with difficulty aScertamed, and as a difcovery :of the faft, could it be determinately made, would prove of very little confequence to the improvenlent of the art of furgery, I thillk it quite unnecefl*aty to dwell won a part of this fabjeft, in which the benefit of mankind appears to be fo little concerned.

Plate VIII. FYg. x. reprefents the upper parts of the two flcones, as they were found lying loofely to gether in the urethra. The longeR ¢nd, that is, the -fmallelt of thefe two flcorles, was ftuated neareR to the neck of the bladder, or orign of the urethra. It may be obServed, that, on the fuperior part of thefe IlarLes, there are two long grooves or chanels, which were gradually formed: by the llreams of urine, that were occafionally diR:harged from the bladder.

R r2 It



[ 3O8 ] It may farther be obServedX that the strllole lur-

faces of thefe two Rones, except the part$ of them where they lay in contaft with cach other, or where they continually preXed upon the lower furface of tlle urethra, or bed, which they had formed for themfelves in this chanel, are rough, and have feveral inequa- Iiis, or eminences arifing from them.

gg. 2. reprefents the inferior fmooth parts of the h^zo Ilones, as they appeared when Separated from each other, as well as the fmooth or polithed furfaces of theends of thefe Ilones, which lay in contad with each other, and upon motion rubbed againk each other.

t s - _

XXXV. Encteriznents on the Tourmalin: y 11#. Bfenjamin Wilfon, F. R. S. In a I-stwer to Dr. Willwam Heberden, F.:R. S.

SIRX Read Dec. 6. Have the pleafure to communicate to

7s9; 1 you fome experimerlts nzade upon the- qourmalin, or XJhJ^one, which you were fo kind as to procure me, together with fome others, rtIteding the vitreous and reiinous eledcricities, as they are called, and the obServations I have made therellpon.

The more I am acquainted with eleEl;ricity, the more I adm;re a wonderful fimplicity whicll feems to prevail in nature, at leafl: in this part which abounds wvith phaenomena of a very curiolls kind; whereof many that have paXed under my examination of late are fo extremely nice, that I avoid venturing to relate them, becauSe I would not witlingly fubjeft myfelf to the cenfure of sncautious obfervers.-

[ 3O8 ] It may farther be obServedX that the strllole lur-

faces of thefe two Rones, except the part$ of them where they lay in contaft with cach other, or where they continually preXed upon the lower furface of tlle urethra, or bed, which they had formed for themfelves in this chanel, are rough, and have feveral inequa- Iiis, or eminences arifing from them.

gg. 2. reprefents the inferior fmooth parts of the h^zo Ilones, as they appeared when Separated from each other, as well as the fmooth or polithed furfaces of theends of thefe Ilones, which lay in contad with each other, and upon motion rubbed againk each other.

t s - _

XXXV. Encteriznents on the Tourmalin: y 11#. Bfenjamin Wilfon, F. R. S. In a I-stwer to Dr. Willwam Heberden, F.:R. S.

SIRX Read Dec. 6. Have the pleafure to communicate to

7s9; 1 you fome experimerlts nzade upon the- qourmalin, or XJhJ^one, which you were fo kind as to procure me, together with fome others, rtIteding the vitreous and reiinous eledcricities, as they are called, and the obServations I have made therellpon.

The more I am acquainted with eleEl;ricity, the more I adm;re a wonderful fimplicity whicll feems to prevail in nature, at leafl: in this part which abounds wvith phaenomena of a very curiolls kind; whereof many that have paXed under my examination of late are fo extremely nice, that I avoid venturing to relate them, becauSe I would not witlingly fubjeft myfelf to the cenfure of sncautious obfervers.-

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An Account of Two Stones of Remarkable Shapes and Sizes, Which, for the Space of Six Years, Were Firmly Lodged in the Urethra of a Young Man, and at Length Successfully Cut out from