An Account of the Case of William Payne, with What Appeared upon Examining His Kidneys and Bladder, When His Body Was Opened; By Mr. George Bell, Surgeon

XV. An Account of the Case of William Payne, with what appeared upon examining his Kidneys and Bladder, when his Body was opened; by Mr. George Bell, Surgeon. William Payne, aged about 71, had been afflicted with the Stone in his Bladder, and other calculous Complaints, for several Years: He had taken Mrs. Stephens's Medicines for 15 Months. See Hartley's View, &c. p. 8. Case III. He was subject also to a scrotal Rupture on the Left Side, from which however he suffered no great Inconveniency, unless upon Neglect of his Trusks, which he had been directed to wear; and even then, if the Intestines came down, he used to return them with Ease. About the Beginning of January last, he was attacked with a severe Fit of the Stone, attended, upon every Attempt to make Water, with a strong Tenesmus, that forced into the Scrotum a considerable Quantity of the Intestines, which exceeding his Skill to reduce, he sent for me. I found the Tumour large and unequal, but without much Tension or Inflammation; his Pulse low, with clammy Sweats; he complained of violent Pains in his Back, propagated thro' the whole Length of the Ureters, accompanied with Nausea and Vomitings; he felt exquisite Pain about the Neck of his Bladder and Glans, with an unusual Weight in Perineo; he had frequent Inclinations to make Water, but seldom made above a Spoonful at once, and that Drop by by Drop, with much Pain, and sudden Stoppings: The Urine was extremely fetid, sometimes mixed with purulent Matter, at others tinged of a Coffee Colour. He had received, just before I saw him, a Clyster, which produced two Stools, and encouraged me to hope might facilitate the Reduction of his Rupture. I attempted it by all necessary means possible, but without Success: For altho' the largest Part receded and gave way, yet a considerable Portion remained, which I could not possibly return. I therefore concluded, as the Intestines performed their Office, and were free from Tension, Inflammation, &c. that the Parts adhered; so left him, with Directions for a Bag-Truss to support them. January the 22d, being informed of his Death, I applied for Leave to open him, which was granted. In examining the Contents of the Abdomen, I found the Left Kidney quite wasted, scarce any thing remaining except the Coats, and those filled with Blood and purulent Matter; the Ureter very much enlarged above its natural Capacity, and full of the same. The Right Kidney was ulcerated in several Places, and full of purulent Matter, mixed with Grit; several Hydatids appeared upon its external Surface; the Ureter was somewhat enlarged. I next examined the Bladder, which was exceeding large, and contained above three Pints of clear Urine; upon opening it and introducing my Hand, I found two smooth flattish Stones, somewhat larger than common Windsor Beans: I discovered a third in the Neck of the Bladder, which probably had been forced there during the Paroxysm, and appeared to me to be the the immediate Cause of his Death: It was about the Size of a Filbert, and had quite corked up the Passage. Upon dissecting the Hernial Bag, the first Part that presented was a large Piece of Fat, about half a Pound; and immediately underneath it lay a large Portion of the Colon, in Length about 10 Inches; the internal Surface of the Peritoneum was strongly attached to the Colon by several Filaments, and to the Scrotum by its cellular Substance. All the other Viscera were in a natural State. Printed for T. Woodward, at the Half-Moon, between the Two Temple-Gates in Fleetstreet; and C. Davis, the Corner of Pater-noster-row, next Warwick-lane; Printers to the Royal Society. M.DCC.XLII. ADVERTISEMENTS. A New Map of the Virgin Islands, taken from an actual Survey made at the Expence of the Honourable Gilbert Flemming, Esq; Governor of St. Kitts. Sold by W. Mount and T. Page, Stationers, on Tower-hill, London. The Gardener's best Companion in a Green-house; or, A Table, shewing the greatest Heat and Cold of most Countries; with a Catalogue of Exotic Plants, under the Name of each Country which produces them. Likewise, Thermometers, Hygrometers and Barometers, either for common Use, or adapted to the Use of Green-houses, made and sold by Tim. Sheldrake, at the Black-Boy over-against Cecil-street in the Strand, London.