The Effects of the Lixivium saponis, Taken Inwardly by a Man Aged 75 Years, Who Had the Stone, and in Whose Bladder, after His Decease, Were Found Two Hundred and Fourteen Stones: From William Cheselden, Esquire

VII. The Effects of the Lixivium Saponis, taken inwardly by a Man aged 75 Years, who had the Stone, and in whose Bladder, after his Decease, were found Two hundred and fourteen Stones: From William Cheshelden, Esquire. Read Jan. 13. May 21. 1739. Laurence Welch, aged 75, born in Denmark, but at that time a Pensioner in his Majesty's Royal Hospital at Chelsea, after having had Symptoms of the Stone for eight Years, but never known to void any in all that time, began to take ten Drops of Lixiv. Sapon. in half a Pint of Water, three times a Day; and on the 23d in the Evening voided several small Scales of Stone, with little or no Pain. On the 24th the Dose was increased to fifteen Drops; but, making him very sick, was reduced on the 25th to ten. He complained of great Pain in his Back this Day, and at Night pass'd a whole Stone, the Size of an Orange-kernel, and several little Bits. On the 26th he complain'd of great Soreness in the Urethra when he made Water; for which a little Oil was injected, and he took eight Ounces of a Solution of Gum-Arabic inwardly, omitting this Day the Lixivium. Being very easy on the 27th, he took the Lixivium as before: His Urine was thick and plentiful, but had no Gravel or Sand in it. On the 28th he took the *Lixivium*, and about four in the Afternoon voided several Bits of small Stone, of different Make and Texture, some as large as Tares; which making the *Urethra* very sore, on the 29th he omitted the *Lixivium*, and took a Solution of the Gum, and had the Oil injected as before. Being search'd this Afternoon, we perceived a great Quantity of Stone in his Bladder. On the 30th he took the *Lixivium* again, was very sick, but easy. The 31st, taking the *Lixivium* after great Pain in his Back, Belly, and *Penis*, he pass'd a large Piece of Stone, with several smaller Bits. *June 1.* he took nothing, was very easy, and made a great Quantity of thick turbid Urine. He took the *Lixivium* again the next Day, was very easy, and continued so all the 3d; but on the 4th was in great Pain all Day and Night. On the 5th, the Medicine having sat well on his Stomach these three Days, I ventur'd to give him fifteen Drops of the *Lixivium*; and, after having great Pain in his Loins and *Penis*, at Night he voided several large Bits. Early in the Morning, after very great Pain, on the 6th, he voided three large Bits of Stone, and in the Afternoon several more Pieces came away; one of which was the largest yet voided. He took the *Solut. Gum. Arab.* this Day, and no *Lixivium*; and at Night, being faint and fatigued with Pain and Want of Rest, he had an Opiate and cordial Julap. On the 7th he likewise took no *Lixivium*, having great Pain and Sickness at his Stomach. His Urine To-day appeared a little bloody, and had a tough tough Mucus in it, which sunk to the Bottom of the Pot, and was very fetid. In the Afternoon a large Piece of Stone stopt at the Extremity of the Penis; which, after endeavouring for two Hours to press out with his Fingers in vain, was extracted, by enlarging the Orifice. This Stone weigh'd but nine Grains and a half, tho' near as large as a Die; and two which he voided before, near as big, and of a triangular Form, weigh'd, one, eight Grains, the other, seven and three Quarters. This Day he took the Solut. Gum. Arab. and at Night had an Opiate and cordial Julap, to take a little of now and then. On the 8th he took nothing; and tho' he had a great deal of Pain, and was very weak, had a better Appetite than any Day since he began the Course. He complain'd of Pain, in the Morning on the 9th; so took no Medicine; was very easy the rest of the Day, and pass'd some very small Scales. On the 10th he took the Lixivium, and was pretty well. The 11th had great Pain, and was very sick; and also on the 12th: Therefore he omitted the Lixivium on the 13th; and, being very faint and low, had a cordial Julep. On the 14th he took the Lixivium, and was very easy every Day till the 20th, when he complain'd his Water made him smart; and also the 21st. The 22d he was very full of Pain, and sick; therefore on the 23d he took only the Solut. Gum. Arab. was easy, and had a great deal of Mucus come away with several small scaly Bits of Stone in his Urine; and also on the 24th and 25th. He complain'd of great Pain in the Glans Penis on the 26th; and his Belly swell'd, and pitted just above above the Os Pubis; and he voided some small Bits in a great Quantity of Mucus. On the 27th a few little Bits were voided, and he had no Pain all Day. The 28th he had great Pain, and made very little Water; but on the 29th made a great deal of Water. His Belly was swell'd, and he complain'd of great Pain in his Loins. —— He voided some small Bits of Stone on the 30th, which was the last Day he took the Lixivium. The 1st of July he took the Solut. Gum. Arab. and was in great Pain. On the 2d, being very faint, and wanting Rest, he had a cordial Julep and quieting Draught; and the 3d and 4th; which Day he complain'd of great Pain in his Limbs; and on the 5th had several loose Stools; which however stopt on the next Day. He continued languishing, and in extreme Pain all over his Body, even his Fingers and Toes, from this Day to the 24th of July, not being able to bear being touch'd in any Part of his Body or Limbs, some Days before his Death, which was on that Day, being 64 Days since the Commencement of this Course: In which Time he took 81 Doses of the Lixivium, being one Day with another (till he left off entirely, which was 24 Days before he died) about 20 Drops a Day. During the Course, his Water was generally thick and muddy; tho' when in great Pain, sometimes clear and high colour'd. In about three Weeks after he began, there was a great deal of that tough fetid Mucus in his Urine, which continued till he left off taking the Lixivium, and then decreased considerably, till till a Fortnight before his Death, when it entirely disappear'd, and his Urine had no Smell or Taste, and came away involuntarily. On straining and filtrating the Urine, I often found little scaly Bits, very small, which, when dry rubb'd, became an impalpable Powder. After he left off the Medicine, I could never find this in the Urine, tho' I search'd very carefully. His Diet the whole Time was chiefly Spoon-meat; now and-then a little Meat, but very seldom; and he had but little Appetite when he began, and was very weak. On opening the Body I found his Kidneys very sound, and neither Stone nor Gravel in them: But in his Bladder there were two Hundred and fourteen Stones; the two biggest about the Size of Nutmegs, the others gradually less, to the Bigness of a Pca, and smaller, but each whole, not Pieces. They were of a soft chalky Substance and Colour, and weigh'd all together six Ounces Averdup. two Scruples and four Grains; besides which there were several small Scales, such as I found in his Urine. The other Viscera had nothing remarkable. The Quantity of small chalky and scaly Bits and Powder that I could save out of the Urine, was about as much in 24 Hours as would well cover a Shilling; and perhaps there might be as much more lost in his Urine, when at Stool, and on the Sides of the Pot and Urinal.