Chapter VI: Part III: chap. vii (5)

_Mary Hibbard_, a Woman twenty-four Years of Age, was
admitted into _St. George_'s Hospital, the 6th _June_ 1759,
for a Complaint of her Bladder. The Account she gave of
herself was, that, about _Christmas_ 1758, she had parted
with some Gravel; and about fourteen Days before coming to
the Hospital, she was seized with a violent Pain in her Back
and Loins, attended with a Sickness and Nausea; and very soon
after complained of a violent Pain in the lower Part of her
Belly, and with a perpetual Inclination to make Water, though
she felt a sharp Pain and Difficulty in doing it; and that
these Complaints still remained. Her Pulse was quick and
strong, and she was inclined to be costive. She was
immediately blooded, took the oily Draughts three Times
a-Day, the _decoctum furfuris_ for common Drink, and so much
lenitive Electuary as procured her a Stool next Day. As there
was a strong Suspicion of her having a Stone, she was
sounded; but nothing at all was to be felt in the Bladder.
Her Medicines eased her Pain in making Water, but not the
Pain in her Back. On the 16th her Water was thick and turbid,
and deposited a brown Sediment; and the Difficulty in making
Water still remained; instead of the lenitive Electuary she
was ordered the Rhubarb oily Draught to be taken every Night.
On the 18th, there being no Change in her Disorder, she had
Draughts made of an Ounce and a Half of simple Mint Water,
Half a Drachm of the dulcified Spirit of Nitre, and five
Drops of the _tinctura thebaica_, and Syrup three Times
a-Day; but on the 22d she complained, that since she left off
the oily Medicines, her Pain and Difficulty in making Water
had grown worse; she was therefore ordered the saline and
oily Draughts alternately, and to take the Rhubarb oily
Draught occasionally when costive, which removed these
Complaints; and they did not return while she remained in the
House; but on the 4th of _July_, the Day before she was to
have been discharged as cured, she was attacked with a sharp
Pain in her Hip and Loins, and about the _os coccygis_; which
increased till the 9th, and extended itself all along the
Outside of the right Thigh; it was most acute about the _os
coccygis_; but on examining, nothing was to be observed
externally: This Pain continued more or less all that Month,
and till the End of the next, and so obstinate as not to be
altered by bleeding, and the Use of Liniments, Blisters,
cooling Medicines, Opiates, warm Baths, and other Remedies.
On the 20th of _August_, a strengthening Plaister was applied
to her Back, which gave immediate Relief, and she was
discharged cured the 29th. She continued well till _October_,
when she was attacked with a violent Fever at _Hounslow_, and
was brought to the Hospital on the 24th of that Month, and
the tenth Day of the Fever. She died the 3d of _November_.
During the Course of the Fever, she only complained once of a
Difficulty of making Water.--After Death I had her Body
opened, when the only Thing particular which we could
observe, was the urinary Bladder about four times the natural
Size; it seemed to be flaccid, and in a State of Relaxation;
the Kidneys were sound, and no Signs of any Distemper could
be observed about the Uterus or Rectum, or near the _os
coccygis_.--When she was first in the Hospital, I desired her
always to examine her Urine; but she never observed that she
passed any Sand, Gravel, or any thing of that kind.

_Thomas Jacey_, an elderly Man, was admitted into _St.
George_'s Hospital the 14th of _March_ 1759, for a Pain in
his Back, and a Difficulty and Pain in making Water, which
was often mixed with grumous Blood; but he had never observed
any Sand or Gravel in it. His Pulse was quick and full,
attended with Heat and Thirst; and he was inclined to be
costive; he was at first blooded, and took a Dose of laxative
Mixture, and two Ounces of the Tincture of Roses, four Times
a Day, and the _decoctum malvæ_ for common Drink. At first he
seemed relieved, and passed no grumous Blood for some Days;
but on the 26th, as he complained much of a Pain in making
Water, the Tincture of Roses was changed for the oily
Draughts, and he was ordered the Rhubarb oily Draught
occasionally. On the 9th of _April_ he fell suddenly into a
comatose Way, and remained so till the 12th, when he died,
notwithstanding the Use of divers Remedies.--Upon examining
his Body, both Kidneys were found in a sound State; the
Intestines covered with slight inflammatory Spots, the
Bladder of Urine quite contracted, schirrhous, and greatly
thickened; and its internal Surface rough and eroded, with
one or two black Spots on it, and some grumous Blood lying on
its Surface. The other viscera were sound.

In Ulcers of these Organs, the natural Balsams, mixed with
soft Things, are often of great Service; of which the
following Case is an Example.--_William Lumley_, a Boy nine
Years of Age, was admitted into _St. George_'s Hospital, the
6th of _September_ 1759, for a Pain in the Bladder, and a
Difficulty in making Water, which was always more or less
mixed with Matter. At first there was a Suspicion of his
having the Stone; but on sounding, none was to be found. From
the Symptoms, it appeared as if there was an Ulcer in the
Bladder near to its Neck; the Boy had a Cough, was very low,
and inclined to be costive; at first he took three Spoonfuls
of the Sperma Ceti Mixture four Times a-Day, and a Dose of
Physic; but the Symptoms still remaining, on the 2d of
_October_ he was ordered to take a Scruple of the
_electuarium e spermate ceti_ three or four Times a Day, and
to have the Gum-Arabic Decoction for his common Drink. By
continuing the Use of these Things, and taking some opiate
and laxative Medicines occasionally, he mended by slow
Degrees, and all his Symptoms went off; and he recovered his
Health and Strength, and returned Thanks for his Cure the
18th of _January_ 1760.

The following Account of a remarkable Suppression of Urine I
had in a Letter, dated the 25th of _November_ 1757, from Mr.
_Pearson_, one of the Surgeons to his Majesty's Military
Hospitals, who then served as a Mate.

_James Ruffendal_, aged Twenty, of a delicate Habit, was, in
the Middle of _July_ last, seized with a violent Pain in both
Kidneys, which extended along the Ureters to the Bladder, and
remained in the same Situation for about three Weeks; during
which Period his Urine began to decrease in Quantity, and the
voiding of it was attended with acute Pain about the Neck of
the Bladder. The Secretion then totally stopt; he remained
for upwards of five Weeks in the Hospital at _Dorchester_,
and made no Water; at the End of which Time I first visited
him along with Mr. _Adair_. He complained then of a slight
Pain in his Kidneys, and told us he had a tolerable Appetite,
sweated little, and voided every Day four or five Liquid
Stools. He was ordered Boluses of Camphor, and _sal. vol. c.
cervi_, and every Night a Dose of _tinctura cantharidum_;
which he continued to take for a Fortnight without receiving
the least Benefit. I then blooded him to the Quantity of ten
Ounces, and gave him an Emetic of six Drachms of the _vinum
ipecacoanhæ_, and two Ounces of the Oxymel of Squills, which
operated very well; and afterwards ordered him to take one of
the following Boluses every four Hours. Rx Sapon. dur. Hispan.
drachm. i. Sal. Absynth. gr. vi. Calc. Viv. gr. x. Balsam.
Peruv. q. s. ut fiat Bolus. These he continued to take for
twelve Days. On the Morning of the 14th of _October_, he was
suddenly seized with an acute Pain in both Kidneys, and about
Noon voided upwards of Half a Pint of straw-coloured Urine,
which let fall a clay-coloured Sediment. As he was feverish,
I took away twelve Ounces of Blood, and ordered him
Barley-Water with Nitre for Drink. He was easy in the Night,
and made upwards of two Pints of Urine, which deposited a
Sediment of a gelatinous Consistence. Next Morning the Pain
increased, especially in his Right Side, and ten Ounces more
of Blood was taken away. This lowered the Pulse, and
considerably abated the Pain. Both this and the Blood taken
away the Day before threw up an inflammatory Buff. He was
ordered to continue the Use of the Barley Water with Nitre,
and to take three Spoonfuls of a Mixture with _spiritus
mindereri_ every two Hours. He had an easy Night, and was
next Day free from Fever; but complained of an Uneasiness in
his Stomach and Nausea. He was ordered a Scruple of the
Powder of Ipecacoanha, which vomited him, and procured him a
Stool. He was easy in the Night; but in the Morning was hot,
and complained of a Pain in his Right Kidney, and all over
his Bones, as he expressed it. I then gave him a Mixture,
with _spiritus mindereri_, and the _pulvis contrayerva comp._
of which I desired him to take some Spoonfuls frequently.
This procured him a plentiful Sweat, which removed the Fever
and Pain: these Symptoms returned next Day, but were removed
by the same Means. I remained at _Dorchester_ for a Week
after, and he recovered his Strength and Appetite as much as
could be expected in so short a Time; but he still complained
of Pain in his Right Kidney, tho' he made Water freely. By a