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CHAP. XXXV. Of the signs of the Stone in the Kidnies and Bladder.
* 1.1THe signs of the Stone in the Reins, are the subsiding of red or yellow sand in the urine, a certain obscure itching at the kidnies, and the sense of a weight or heavi∣ness at the loins, a sharp and pricking pain in moving or bending the body, a num∣ness of the thigh of the same side,* 1.2 by reason of the compression caused by the stone, of the nerves descending out of the vertebrae of the loins of the thigh. But when the stone is in the bladder, the fundament and whole perinaeum is pressed as it were with a heavy weight, espe∣cially if the stone be of any bigness, a troublesom and pricking pain runs to the very end of the yard, and there is a continual itching of that part, with a desire to scratch it: hence also by the pain and heat there is a tension of the yard, and a frequent and needless desire to make water, and sometimes their urine cometh from them drop by drop. A most grievous pain torments the patient in making water, which he is forced to shew by stamping with his feet,* 1.3 bending of his whole body, and the grating of his teeth. He is oft-times so tor∣mented with excess of pain, that the Sphincter being relaxed, the right gut falleth down, ac∣companied with the swelling heat and pain of the Hemorhoid veins of that place. The cause of such torment is, 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 the parts of the belly come as it were for supply. The sediment of the urine is gross and viscid, and oft-times like the whites of eggs, which argueth the weakness of the native heat not at∣tenuating the juices. The patient looketh of a pale and yellowish complexion and hollow-eyed, by reason of the almost continual watching which is caused by the bitterness of pain; yet may it more certainly be known by putting in or searching with a Catheter. Which to do,* 1.4 the patient shall be wished to stand with his body somewhat stooping, leaning against somewhat with his back, and holding his knees some foot asunder. Then the Catheter being bigger or lesser as the body shall require, and anointed with oil or butter shall be thrust with a skilfull hand into the passages of the urine, and so into the capacity of the bladder. But if the Catheter cannot come to that capacity, the patient shall be placed in such a po∣sture; then shall he be laid upon his back on a bench, or the feet of a bed, with his knees bended, and his heels drawn to his buttocks, after which manner he must almost lie when he is to be cut for the stone, as shall be shewn hereafter. For thus the Catheter is more easily thrust into the bladder, and shews there is a stone by the meeting and obscure sound of the obvious, hard and resisting body. You must have sundry Catheters, that they may serve for every body bigger and lesser, and these must be crooked, smooth and hollow. When being thrust into the urinary passage (which before unawares I omitted) they come to the neck of the bladder, they must not be thrust straight into the bladder; but taking hold of the yard with the left hand, they must be gently thrust with the right directly into the bladder, especially in men, by reason of the length and crookedness of the way, which tends in the form of this letter S.* 1.5 It is not so in women by reason of the shortness and straitness of the neck of the bladder. It is fit your Catheters be hollow or fistulous in manner of a pipe, that they may receive a silver wiar or string, that may hinder the gross and viscid humor, clotted blood, or the like, from stopping the further end of the Catheter, through which the sup∣pressed urine ought to pass and be made. But now as soon as we perceive that the Catheter is come into the capacity of the bladder, the wiar must be drawn forth, that ••o the urine may the freelier flow out by the hollowness of the Catheter. You may perceive the shapes of these instruments by this following figure.