A Letter from Mr. Charles Bernard, Giving an Account of Two Large Stones, Were for Twenty Years Past Lodg'd in the Meatus Urinarius, and Thence Cut out by Him the 28th of September Last

VI. A Letter from Mr. Charles Bernard, giving an Account of Two large Stones, were for twenty Years past Lodg'd in the Meatus Urinarius, and thence cut out by him the 28th of September last. I am neither to deny nor defer giving you the History of those Stones which I lately cut out of the Vrethra of a Gentleman, who had born them there many years, without knowing what his Distemper was. And however averse I may be from an Attempt of this kind, either from the natural Laziness of my temper, or the sense of my own Inability; yet I take this to be a case surprising and unusual, that the Publick seems to exact it from me, altho' I did not stand engag'd to you by my promise for the Performance. A case so very rare and extraordinary, that (with all its circumstances considered) I shall not fear to pronounce it the single instance of the kind; my own Experience, I confess, is too narrow for me to pretend to have met with the like: And sure I am, that among the few Books of which I am possess'd, and with which I have been conversant, I cannot find any example which holds any proportion with this; to have a Stone lodg'd in the Meatus Urinarius, and to be thence cut out, is no uncommon Accident, but is what, at one time or other, occurs in the Practice of most Men; but to have Stones of such a Magnitude, manifestly lodg'd in this part for near Twenty Years together, and the Disease never discovered, and no reasonable attempts made towards the Relief of the Patient, to those who have the Story only upon the Authority of the Relator, will seem altogether incredible. J. Ban- J. Bauhine indeed met once with a Case, in a Name-sake of my own, who had, aliquot calculos, some Stones which lay moveable in the middle of the Vrethra, for the space of a Twelve-month, about the bigness of Cherry-Stones, one of which at length was voided, the other which remained (which, whether ever remov'd or not, is not said) continued something incommodious to his making Water, tho' without any remarkable Pain. This was thought Mirabilis affectus ante non visus, If that were so wonderful, what shall we conclude of that which I am about to relate. About a Fortnight since, I was carried to Dr. Beaufort, to one Mr. Blondel, a Gentleman, whom he had lately recovered from a Feverish Indisposition; from which, when he found himself Relieved, he complained to the Doctor of a very hard Swelling, a little behind the Scrotum, which had remained there many Years, and created great uneasiness to him. The Doctor looking upon it, told him 'twas Surgeons Work, and was pleased to advise him to send for me. The next Morning we went together, and upon Examining it only with my Fingers, I immediately declared it to be a Stone of a very odd and irregular Figure; and that there was no way of Removing it, or Relieving him, but by cutting it out. He was very much Dejected with the Apprehension of another Operation; having about twenty Years since, while a Lad, been Cut by Mr. Hollier for the Stone in the Bladder, and in great danger from it: But considering the Misery of his Life, and upon my assuring him, that it would not be attended with the Danger and Difficulty which are dreaded, upon the Extraction of a Stone out of the Bladder; and that there was no Prospect of Relief by any other Method, he determined to submit to the Operation. But before I proceed to give the Relation of that, order seems to require, that you should have an Account of the Disease, and the Symptomes antecedent; as well as I could myself be instructed, he had not long Recovered from under Mr. Hollier's Care, before he began to complain of Pain, which resembled his old Pain of the Stone; and this continued upon him for 4 or 5 Years, before he was sensible of any Fullness or Swelling in Perinaeo, which you are to suppose at first but small. I am inclined to believe, that Mr. Hollier left either a couple of little Stones, or pieces of Stone at the time of Extraction, which were by degrees protruded into the Vrethra; but being too big to be voided, there lodged themselves, and so by perpetual accretion, arrived to that Magnitude which you see. He constantly complained of Pain in making Water, which ordinarily flow'd guttatim, and involuntarily for several Years past. Nor was he longer at ease, then while his Bladder was full and distended with Urine; which Distention was continued all along the Neck and the Vrethra, as far as where the Stones were bedded; for his only way of procuring ease to himself, was by frequent drinking very large quantities of small Beer or Water; and as soon as the Separation could be made of the Urine into the Bladder; and while that continued full, he was sensible of some ease. He has been likewise exceeding liable to Vomiting of late, and generally molested with a Diarrhoea for some Years past; both which had lately so increased upon him, as very much to have impaired his Health, and weakned his Constitution. I am now only to tell you, that having prepared him with such Evacuations, as are proper to precede such an Operation, on Monday the 28th of September last; I perform'd it, by cutting upon the most protuberant part of the Stone, (which I then supposed to be but one) and making my Incision pretty large, the upper part, which proved a distinct Stone, and had form'd it self a Socket in the lowermost, slipt out with little or no difficulty; the other, which was forked, and was as it were bound in, as if it had adhered to the Urethra, was remov'd with more trouble, and broke in the taking out, they being neither of them very hard. There was not an Ounce of Blood lost in the Operation; the Stones having lodged long there, you must imagine had made a very great Distention of the Urethra, so that it was become so callous, that I seem'd to cut through a Cartilage: The Stones being thus taken out, I had nothing else to do but to Dress up the Wound, which continues in a very good Condition, tho' we have to do with a very shattered and capricious Constitution of Body. I had almost forgot to tell you, that to facilitate my removal of that Stone which was locked in, I put two of my Fingers up his Fundament, to secure it from retiring towards his Bladder; and to my surprize I found, that one of the Angles of it had perforated into the Anus, which the Nurse hearing me mention to the Doctor, reply'd, that 'twas no wonder that in the Morning she was not able to pass up the Clyster-pipe. Tours, &c. The Figure and position of the Stones deserve your Notice: A The Point which tended towards the Glans. B That part which lay in the Acetabulum. C The part upon which I made Incision. D The Acetabulum. E The point which lay towards the Neck of the Bladder. F That which had Perforated into the Anus.