The workes of that famous chirurgion Ambrose Parey translated out of Latine and compared with the French. by Th: Johnson

CHAP. XXXV. Of the signes of the stone of the Kidneys and bladder.

THE signes of the stone in the reines, are the subsiding of red or yellow sand in the urine, a certaine obscure itching at the kidneys, and the sense of a weight or heavinesse at the loynes, a sharp and * 1.1 pricking paine in moving or bending the body, a numnesse of the thigh of the same side, by reason of the compression caused by the stone, of the nerves discending out of the vertebrae of the loynes of the thigh. But when the stone is in the bladder, the fundament and * 1.2 whole perinaeum is pressed as it were with a heavie weight, especially if the stone be of any bignesse, a troublesome & pricking pain runs to the very end of the yard, and there is a continuall itching of that part, with a desire to scratch it: hence also by the paine and heat there is a tension of the yarde, and a frequent and needlesse desire to make water, and sometimes their urine commeth from them drop by drop. A most grievous paine torments the patient in making water, which he is forced to shew by stamping with his feet, bending of his whole body, and the grating of his teeth. He * 1.3 is oft times so tormented with excesse of paine, that the Sphincter being relaxed, the right gut falleth downe, accompanied with the swelling heate and paine of the Haemorrhoid veines of that place. The cause of such tormentis, the frequent striving

of the bladder to expell the stone wholly contrary to the nature thereof, whereto by sympathy the expulsive faculty of the guts and all their parts of the belly come as it were for supply. The sediment of the urine is grosse & viscid, and oft-times like the whites of egs, which argueth the weaknesse of the native heate not attenuating the juices. The patient looketh of a pale and yellowish complexion and hollow eyed, by reason of the almost continuall watching which is caused by the bitternesse of paine; yet may it more certainely be knowne by putting in, or searching with a Ca∣thaeter. * 1.4 Which to doe, the patient shall bee wished to stand with his body somewhat stooping, leaning against somewhat with his backe, and holding his knees some foot asunder. Then the Cathaeter being bigger or lesser as the body shall require, and a∣nointed with oyle or butter, shall bee thrust with a skilfull hand into the passage of the urine, and so into the capacity of the bladder. But if the Cathaeter cannot come to that capacity, the patient shall be placed in such a posture; then shall he be layd up∣on his backe on a bench, or the feet of a bed, with his knees bended, and his heeles drawn to his buttocks, after which manner he must almost lie when he is to be cut for the stone, as shall be shewen hereafter. For thus the Cathaeter is more easily thrust in∣to the bladder, and shewes there is a stone by the meeting and obscure sound of the obvious, hard and resisting body. You must have sundry Cashaeters, that they may serve for every body bigger and lesser, and these must be crooked, smooth and hol∣low. When being thrust into the urenary passage (which before unawares I omit∣ted) they come to the necke of the bladder, they must not be thrust streight into the bladder, but taking hold of the yard with the left hand, they must bee gently thrust with the right directly into the bladder, especially in men, by reason of the length and crookednesse of the way, which trends in the forme of this letter S. It is not so in * 1.5 women by reason of the shortnesse and straitnesse of the necke of the bladder. It is fit your Cathaeters bee hollow or fistulous in manner of a pipe, that they may receive a silver wiar or string, that may hinder the grosse and viscide humour, clotted blood, or the like, from stopping the further end of the Cathaeter, through which the sup∣pressed urine ought to passe & be made. But now assoon as we perceive that the Ca∣thaeter is come into the capacity of the bladder, the wiar must be drawn forth, that so the urine may the freelier flow out by the hollownesse of the Cathaeter. You may per∣ceive the shapes of these instruments by this following figure.

[illustration]

The figure of Cathaeters, and of a silver string or wiar.

Notes

• * 1.1

  Why the thigh i•…•… ••umme in the stone of the reines.
• * 1.2

  Signes of the stone in the bladder.
• * 1.3

  Why such as have a stone in the bladder are troubled with the falling of the fundament.
• * 1.4

  How to sear••n for the stonein the bladder with a Cathaeter.
• * 1.5

  The figure of the necke of the bladder is different in men and women.