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PROBLEM VI

Whether Cancers are Curable by internal Medicines

THOUGH this Problem at first View may seem to be too near allied to that which proves the Impossibility of curing cancerous Tumours, whether ulcerated or not, by Salivation; yet in regard there are some Persons, that tell us the Disease is superable by some internal Remedies, which operate after a quite different Manner, to those generally given to procure a Salivation, we shall enquire into one of the most considerable of them, related by a Person whose Memory we have a very great Value for. And we shall the rather take Notice of this particular Remedy, because we have elsewhere spoke of the Success of it. It were no very difficult Matter for me to mention several internal Medicines, out of our Chirurgical Writers, more especially those that have been Favourers of Chemistry; but I shall purposely decline it, because to speak freely, I suspect that most of the Remedies, though much has been said in the Praise, have not been sufficiently examined by those that recommended them. To this we may add, that had the Authors of them considered the vast Difference there is to be observed in Cancers, they would not have so suddainly and positively determined, that their Medicines were of use in these Cases in general; seeing we must have regard to absolutely different Intentions, in those that are not ulcerated, and those that are, and those that are a hard Tumour, and those that are flat, and likewise when they are conjoined with Circumstances, which are often enough to be met with. The Honourable Mr Boyle in his Usefulness of experimental Philosophy, tells us, that he was informed by credible Persons, of a certain English Woman above sixty Years of Age, who had lain long indisposed with a Cancer in her Breast, in an Hospital in Zeeland, and was by Doctor Harberfeld, with one single inward Remedy perfectly cured in three Weeks; the Relation was made by a Doctor of Physick, who was an Eye Witness of the Cure, and another Person who not only saw the Cure, but knew the Woman before, and out of Charity, carried her to him that healed her. Our Author was informed, that the Chemical Liquor the Doctor constantly made use of, does in the Dose of about a Spoonful or two, work suddainly and nimbly enough by Vomit, but hath very quickly ended it’s Operation, so that within an Hour, or less, after the Patient has taken it, he is commonly well again, and very hungry. He adds, that having some of the Liquor presented him, he found the Taste to be offensive enough, and not unlike that of Vitriol, which by the Taste and emetick Operation, was guessed to be it’s principal Ingredient. The Relators assured our Author they had been in England, as well as elsewhere partly Eye Witnesses, and partly Performers of wonderful Cures by the help of it alone, under God, in the King’s Evil; insomuch, that an eminent Gentleman of this Nation, hath been cured by it, when that Distemper had brought his Arm to such a pass, that the Surgeons had appointed a time to cut it off. Now, who is there, that upon reading this Account would not think the Doctor a very happy Man, that was Master of so valuable a Secret; but alas! How satisfactory would it be to the World if the hundredth part of the Remedies that have been handed down to us, had a Power of effecting those things that are ascribed to them, without being attended with any ill Consequences. I assure you, Reader, I have made use of this very Remedy, for since I mentioned it as the Doctor’s having great Success from it; I met with the true Preparation of it, as it was communicated to Sir Kenelm Digby by Doctor Havervelt, or Haberfield, for the Cure of Cancers, the King’s Evil, and old Ulcers. It is as follows. ℞ Dantzick Vitriol, calcine it till it be yellow, then grind it with Salt, or Salt Petre, the ordinary proportion with this Sublime Mercury, which Sublime once again by it self, then take only the Cristaline part of it; of this take ℥i, grind it to a Subtile Powder in a Glass Mortar with a Glass Pestle. Put this into a Glass Bottle, and pour upon it a Quart of Fountain Water, stop the Bottle close, and let it stand thus for some Days, shaking it often; after it is well settled pour off the clear, and filtre it; take a Spoonful of this Liquor, which put into a Vial, and put to it two Spoonfuls of fair Water; shake the Vial well, and let the Patient Drink it in the Morning Fasting: As to the quickness of its Operation, and the making the Patient Hungry, I found it at first to agree with what Mr Boyle says of it; but upon giving it three or four times, the Patient would afterward complain of a Languidness, which was ushered in by a Sickness at the Stomach; after this, they would be attended with a Heat or Soreness of the Throat, immoderate Thirst, convulsive Motions of the Stomach, &c. Some of which Inconveniencies would continue for many Hours together. It was upon Account of the Melancholy Reflections of bringing the Patients into such Disorder, and their Unwillingness to endure such Fatigues, that I had never Courage enough to proceed in this Method. I cannot but say, upon the Alteration I found in a Patient of mine, from the use of six Doses of this Medicine, that it may as well as some other churlish Remedies, cure some flat ulcerated Cancers, where there is no Tumour to dissolve, in Persons that are capable of often repeating it, which I think is sufficient to put us upon farther Enquiries, that we may be able to accomplish such Undertakings without bringing upon the Patient such a Train of mischievous Accidents.

POSTSCRIPT

What follows is taken from a Manuscript which at this time 1714–15, belongs to one of the Family of the Pains, that have for a long time pretended to cure Cancers: In the Margin is this Note, (Used by my Father, and Grandfather, and Brothers, and known as a thing excellent by long Practice in our Family of the Pains:) The Book was lent me by my Brother Dobyns, who had it from one of the Family, a Patient of his.

The Red Caustick

To eat all Superfluous Cancerous and Schirrous Matters gathered hard in the Edges or Sides of any Ulcer or Cancer, breeding upon the Mouth, Face, Nose or Valva. Take of Bole Armoniac one Ounce, of yellow Arsnic three Ounces, powder them and searse them fine, pare an Apple or two and take of the Pulp and put so much of it to the Powder (beating of it together in a Mortar) as will make it of the stiffness of Dough, then make it up into round Balls of the bigness of a Walnut, dry them in a Chamber-Window till they be hard enough. When you use these Balls shave a little off from them into your Hand, and moisten the same with a little Spittle, and rub it well about the hard Foot of the Noli me Tangere, and all over the Head of the same, and after that you have gathered him up into the Ligature and knit him hard up (for it seems they used a Ligature smeared with the Medicine) then apply your Preparation before-mentioned, and lay fine Holland Raggs dipt in the following Red Water, all over the said Caustic, and so let it lye till it fall off its self. Note, The Quantity of Caustic laid on, ought not to be much, and yet sufficient to work its effect. It worketh with great Pain for twelve Hours or more, and after that by Fits, like the Tooth-Ach; as the Pain worketh off it causes great Inflammation and Swelling about those Parts it is applied to, but this does not continue above four or five Days; so meddle not with it till the Caustick comes off. Then you may for three or four Days dress the Inflammation with Diachylon Plaister, or the Red Water warm.

The Red Water for a Cancer

Quench unslacked Lime in boiling Water, which let stand six Hours, the clear Water poured off, put to the Fire again; to a Gallon and half of which, put Camphir ℥ß Aloes Succatrine ℥ß. Common Bole ℥ii White Copperas or Allum ℥ii all powdered, which boil in the Liquor a little while: He sometimes gave a Pill made of Deflograted Red Precipitate, which sometimes made them spit a little.

The Musilage Plaister to dissolve Schirrous Knots in the Breast

Take of the white and inward Bark of the Witch-Hasel half a Handful, cut it short and stamp it, then take of the Roots of Marsh Mallows, Holy-hock Roots two or three Roots, clean them and throw away the Pith, stamp all together, then take of Fenugreek and Linseed of each two Ounces powdered, put all in an Earthen-pot, then take a Pint of white Wine or Water, heat it scalding hot, put it to the Things aforesaid, cover it close, stirring it every Day for nine Days, then strain out the Musilage Liquor with which you make the following Plaister. Take a Pint of Salad Oyl, Cerus finely powdered 8 Ounces, boil them together, constantly stirring them, a sufficient time, which you may know by its coming clear off a Pewter Dish when dropt on, let it cool a little and put in your Musilage, which stir till it be as white as you would have it, and until almost all the Musilage be boiled away, then remove it from the Fire and put to it four Ounces of yellow Wax, probably Galbanum may be better, which when dissolved and the Plaister cold, work up for use. This Plaister is sometimes used with equal Parts of Galbanum.

THE CASE OF Dr JAMES KEIL, Represented by JOHN RUSHWORTH

I Should not have been induced to make these Papers publick, barely on account of the rash Censures, that are frequently cast upon the Practice of Surgery, not attended with Success; tho’ that Consideration alone, in the Case of a Person of such Value and Eminency in Physick, as Dr KEIL is known to have been, may be thought sufficient to have moved me to it: But being certainly informed, That several Physicians and Surgeons have before, and since his Death, given themselves the Liberty to reflect, not only upon me for Using, but also upon the Deceased for submitting to the Methods that were taken with him; I think I shall not discharge my Duty, either to my Friend, or to my Self, or indeed to the Profession, if I do not, as far as I am able, endeavour to set what was done in a True Light.

In order thereunto, it may be requisite to look back to the Time He first mentioned any Disorder in his Mouth to me, which was in August 1716. He then told me, He had preceived a Fulness in his Mouth for very many Years; but in the last Three or Four Years it was much encreased, and by the Bulk began to be troublesome to him, tho’ not in the least painful: Upon examining it, I found the Tumour not only large, but also to fluctuate, and therefore told him, until I was satisfied what was contained in it, I could not come to a Resolution, as to the manner of treating it; but, if he pleased, I would make an Incision into it, and then would tell him what I thought was fit to be done; He was very well satisfied, and resolved I should proceed accordingly.

Upon Opening it, there appeared to be nothing contained in it, but Blood; not in the least altered in Colour, Consistence, or Smell, from what is contained in the Vessels. The Tumour presently sunk very much, and I dilated the Incision with my Probe-Scissers, and pressed in some Dossels; and then told him, it was a fleshy Tumour, called a Sarcoma, and that the Blood contained in it was only accidental; and that the best way of extirpating it was by the actual Cautery; but I let him know, that I feared it would be more troublesome to him, and take longer Time to cure, than he seemed to expect.

We presently sent for the best Instrument-Maker the Country afforded, and gave him Directions: But that Night: talking with him of his Case, I desired him to consider, Whether it might not be thought a Slight, by the Learned of both Professions, if I should Perform the Operation, upon a Man of his Character, without a Consultation; there being no Reason (but the Loss of his Time) to be in haste. At first he seemed unwilling to lose so much Time, yet upon Consideration, he resolved for London the next Day, where several Physicians and Surgeons were consulted; they all agreed, it was a simple Sarcoma, and that the actual Cautery was the properest, if not the only means of curing it. This Account I received from the Doctor by Letter; as also, that the Surgeons, upon probing, found the Bone bare, and from the ill Smell concluded it was foul: “Which, said the Doctor it was impossible for you to discover; because after I left Northampton, Two Dossels of the first Dressing dropt out.” I was very glad to hear That, for those Dossels lodging so long, in that warm Part, I was in hopes might be the Occasion of the fœtid Smell; which the Surgeons, not being acquainted with, might fairly be induced to take for that of a foul Bone: Which I mentioned to the Doctor by the first return of the Post; and also, that I was farther encouraged in that Hope, by considering that the Blood, that was discharged at the first Opening, was not at all altered, neither was any Smell perceived, until after the lodging of those Dossels.

Whether the Doctor ever mentioned this my Opinion, to the Surgeons in Town, I know not; but when he returned to me, to have the Operation performed, he seemed discouraged by the Opinion the Surgeons gave of the Bones being foul. But I thought I might make bold to confirm him, in my former Opinion, the ill Smell ceasing without the Assistance of Medicines. The Consequence proved the Assertion: For when, by several Applications of the Cauteries, I had removed the whole Tumor, it was plain to me, the Bone was not affected; and the Part healed as smooth, and with as much Ease, and in as short a Time, as ever I met any thing of that Nature, and the Doctor continued well, without the least Disorder or Complaint, a Year and about Eight Months.

But then in April 1718. He shewed me a small Ulcer, near that Part of the Mouth that was before affected, and told me, He perceived it began upon eating some hot Meat, that stuck to it: At first this healed without much Trouble, but soon excoriated again; and then I could not again perfectly skin it: For as soon as it was almost healed, it would begin to excoriate a-fresh at the Edges, which is what is usual in Phagedænical Ulcers. And tho’ I could digest it, and keep it easy, yet it got ground of me, and spread towards the Teeth; and, near the Root of One of the Molares, laid the Bone bare, which appeared to me at the first not to be injured, but being long exposed became foul. It not exfoliating in due Time, with the Tincture that is commonly used, I proposed the touching of it with a small Cautery, I being able very easily to come at it without making use of a Cannula; which, by confining the Heat, very much injures the neighbouring Parts: The good Effect of which Practice, of not making use of a Cannula, where you can conveniently omit it, I had good Experience of in Doctor KEIL’s former Case: For tho’ he had several Cannulas made in London, by the best Hand, yet after Twice using of them, I told the Doctor, That if a Patient could be trusted, it would be much more easy to him, and the Surgeon would see much better to use the Cautery, than when obstructed by a Cannula. The Doctor was pleased with the Thought, and pressed me, at the next making use of the Cautery, to do it without the Cannula: The Advantage he had by it was, that it bore four Burnings, and said, It gave him not the Pain, or Trouble he had from but One before, and that the Parts were much less Disordered by it afterwards. But to return:

It will not I suppose be doubted, but that proper internal Means were all along made use of: But the Ulcer still appearing to me more threatening, his Friends pressed him, and I more than any, that he would go again to Town, and have the best Advice it could afford; and I resolved to accompany Him, in the Beginning of August 1718. And I cannot forbear saying I was surprized, when, upon a Consultation, my Brothers, Palmer and Brown, made light of it; and, without so much as hearing what I had to say, concluded, That it was chiefly owing to the Bones being foul; and that by drawing a Tooth or Two which they said were affected, and by Purging with Mercurius dulcis, all would be well; and so they took their Leave. Says the Doctor to me, “What say you to this?” I answered him, That I feared they would find themselves again mistaken as to the Surgery Part; and that as to the Mercury, though a good Medicine, He knew he had taken it already several Times, without any considerable Advantage. The Doctor smiled and said, “But since I came so far for Advice, I will not only give them a Tooth, but also try again what Effect Mercury may have.”

Another Meeting was ordered, and the Tooth-Drawer to be there: Upon Drawing the Tooth, it appeared to be very sound. The First Dose he took of Mercury, whether by Cold, or any other Accident, I know not, very much disordered him. I could not conveniently be absent any longer, and therefore the next Day returned into the Country, and do not know how many more Doses the Doctor then took; but in a few Days I received a Letter from him, in which he said, “I know nothing that has succeeded right with me, since I came here: You know what State you left me in, and I was a great deal worse for some Days afterwards; though I hope the Mercury has had no ill Effect, yet I should have been loath to have been so swelled in those Parts, as I have been, willingly. The old Ulcers are not yet healed, they tell me indeed, there is no Appearance of any new Ones, and that the most effectual Methods, which have been taken here, will infallibly prevent every thing, &c.”

But by his next, which I soon received, I had the melancholy News from him, That the Ulcer was broke out again larger than ever, and therefore that he would be down with me in a Day or two, and he came accordingly, but in a worse State than ever before. And though it again digested, and did as before near heal, yet the returns were quicker, and upon every new Eruption it was larger and worse; and so continued to be, notwithstanding all the good internal Methods continually used by the concurring Advice of Dr Mead, Dr Friend, and several other Eminent Physicians; which no doubt was owing to the malignant Nature of it.

And therefore in the Beginning of February last, I could no longer forbear expressing my Fears to the Doctor that it would terminate in a raging Cancer. He was too sensible of it, and told me, “That since I thought I could keep it within Bounds no longer, He was resolved to try what a Salivation would do:” And though I could say nothing as to the Advantage he might expect from it, yet I frankly owned to him, that if it was my own Case, I should be of his Opinion, that I might make bolder with my self, than with any other Patient: But desired by all means, he would first hear if his Friends, the Physicians and Surgeons in London, had yet any other Method to propose, or else would approve of that. He wrote to them, the Answer was long in coming, which made the Doctor express himself to me with more Warmth, than I ever knew him to do before: (For he was a Man of the greatest Command of himself, as well as of the sweetest Temper) “What, says he, is not their Silence enough? And will not you, whom I take for my Friend (for fear of losing your Reputation) assist me in what I desire?” With a great deal more to assure me of his Confidence in me, and of his Opinion of my Ability to take Care of him in the Course. I am not so vain, as to mention all his kind Expressions, yet if it be desired, by any of his Friends, I will give them the Satisfaction of seeing the Letters I had from him, when he was absent from me in London.

At this Time his Brother, Doctor John Keil, came to him from Oxford; and, as I understood afterwards, had seen Dr Friend there, who was for having him salivated at London: But the Doctor being determined to the contrary, did not at that Time acquaint me with it, but began his Course, which I desired might be in the mildest Method, by small Doses of Calomel, encreased gradually, which Method pleased him very well: But Dr Friend (to whom Dr John Keil constantly sent an Account of our Proceedings) gave it as the Opinion of Mr Palmer and Mr Brown, that it should be done by Unction: I gave my Reason to the Patient against it, but they still pressed it, notwithstanding the ill Symptoms, that I thought, at that Time, forbad it; which Symptoms they had been acquainted with. They still persisting, I desired the Doctor would give me leave to write my Opinion my self to Mr Brown, which I did hastily in the following manner.

Good Brother,

I Have seen Dr Friend’s Letter to Dr Keil; and Dr Friend I understand has been so kind as to consult you, and several Others in the Case; whose Judgments, though I have all due Regard for, yet in the present Circumstances (though I give the Preference to Unction in some stubborn Cases) I dare not encourage it in this: For my Reason at first, for beginning so mildly, was, that in this uncommon Case, we might by degrees, make some Judgment of the Effects of Mercury, and then proceed accordingly: For had I not been prevented by the Accidents you have, by Dr Friend, been acquainted with, I should have been very desirous to have gone at least to the Heighth mentioned by Dr Friend. But since I find, by encreasing the Quantity of the Dose to a Scruple (of which he has taken four) it has not affected the Glands at all, or made him Spit the more; but his Stomach is much more oppressed by it, with vast Quantity of Phlegm, viscous to a degree I have not met with, and gives him more than common Disturbance, not to be relieved but by often Vomiting, to which purpose the Turpith, has answered very well for the present: My great Fear is, all things considered, that if I should proceed to Unction, and it should produce the same Effect, that it will be too many for him. If my Fears are too great, my more than common Concern and Friendship is some Excuse for me; as also I desire it may be to You, for this tedious Account from, Sir,

Yours, &c.

Feb. 22d, 1718.

J. Rushworth.

I not receiving, in due Time, an Answer to this, and the Patient being reduced to a great Weakness, and to so great a Disorder, that he could not bear Talking to, I writ these few Lines for him to consider of.

Dear Sir,

AS your Case now stands, I must own my self a Coward: Though Dr Friend is much mistaken to think I am either unacquainted with, or fear the common Accidents that often arise in Salivating: But that irregular and uncommon Effects are, in extraordinary Cases, produced by Mercury, Hale’s Case is to me a sufficient Precedent, of which I have formerly told you the Particulars; and though your Friends in Town took no Notice of the unusual Disorder in your Stomach, yet I should think myself Inexcusable if I should not. And if, upon using an Unction, any irregular Ferments should again arise, weak as you now are, I should dread the Consequence. In these Circumstances, I think it most prudent for me, to advise you, to let what is already taken, go fairly off, and if you find it not effectual, you may with much better Prospect, when you have Strength, begin de Nova, by Unction, and have an Opportunity to have it done by the infallible Men.

Upon this the Doctor no longer, at present, pressed me to use the Unction, and in a few Days, the Force of what he had taken being somewhat spent, he began to get Strength, and the very great Slough (which was one of the Accidents mentioned to Dr Friend) not only cast off, but also healed, as did also the old malignant Ulcer, and all the Parts of the Mouth looked very smooth and well; and the Doctor was very chearful, and in great Hopes of gaining the Point.

At this Time, it being eighteen Days since I wrote to Mr Brown, I received a Letter from him, in which he mentioned nothing to the Purpose. This, I must confess, did not a little warm me; and I the same Night wrote to him again, but never received any Answer: Perhaps he thought mine too hot; if so, if he desires it, both mine, and his that occasioned it, shall be produced.

The Doctor seeing what had been done to have so good Effect, and hoping what was before advised by Mr Palmer and Mr Brown, would effectually prevent any return of his Disorder, resolved to use a Mercurial Unction. He had now more Strength, and therefore I complied with him; I began with a small Quantity, and encreased it every Time, until I had used even a larger Quantity than had been proposed by Dr Friend: But it not in the least affected the Glands, or made him to spit near so much, as when he took the Calomel; neither did the Unction or Calomel produce the Smell, which generally attends Mercurial Courses; and to my great Surprize and Concern, whilst he was using the Unction, the Ulcer broke out again. And by this we were discouraged from proceeding any farther; and in due Time the Doctor endeavoured to Purge this off, but he had always so untoward a Constitution, that neither now, nor at any Time before, could he by Purges have any regular Evacuation; which was, no doubt in his Case, very Injurious to him.

Now I perfectly desponded: But a Friend and Kinsman of the Doctor’s, a Surgeon of no small Reputation, assured him, that he had known, when other Methods failed, a Mercurial Fumigation had answered: And what is it that a rational Man will not try to prevent the excruciating Pains of a Cancer? When the Doctor mentioned this to me, I confessed I knew nothing of that Practice, and always had an ill Opinion of the Fumes of Mercury: And he also owned to me, that he was wholly unacquainted with it; but satisfied in his Friend, and therefore would try it: He began the Course according to his Friend’s Directions; I never pretended to order any thing afterwards; but however still frequently visited my Good Friend, though with an aking Heart. The Fumigation not only made him spit, whilst he was using it, but also for some Hours afterwards; and the Patient continued to use it for several Days, but without any good Effect upon the Ulcer. In about ten Days after he had left off the Fumigation, a very hard Tumour began to arise, upon the Muscles of the lower Part of the Face and Neck, and increased very fast, and in a very short Time spread it self from Ear to Ear: and, by the Bulk, in a great measure prevented his Swallowing, and soon suffocated him. He was Chearful, and to all outward Appearance tolerably easy to the last, and had what he now desired, a gentle Release, July 16, 1719.

And thus, to the Misfortune of Mankind, it is manifest to me, that Mercury is not adequate to this Herculean Distemper: but however, this Case, and That I mentioned before to the Doctor, gives me good Reason to believe, that Mercurials do at least blunt the Acrimony of the Humour, and so procure Ease. For, though that Patient had most acute Pains, before he entered into a Mercurial Course, yet afterwards he was easy all a long, as he told me; for I was called in but a few Days before he died. These, and other melancholly Cases, should not however, I think, wholly discourage Surgeons from making rational Attempts upon a Distemper, which I fear is more frequently met with, than formerly, in this Part of the World: It is to be hoped, there is in Nature a Specific that may answer; and happy will that Man be who shall discover it. He will deserve to be placed next to the Great Hippocrates, and also to be rewarded, by the Publick, equally with him that shall find out the Longitude.

I will not pretend to determine, how far the Fumigation might contribute to the sudden growth of the Tumour mentioned, but I should be very glad that the Surgeon who recommended it, would be so ingenuous, as to vindicate himself, by giving Instances of it’s Innocency, and of the Advantages he has met with in the Practice of it.

And now I heartily beg Pardon of the Friends of the Deceased, who shall give themselves the Trouble of Reading this Account, that I could not bring it into a narrower Compass.

Having truly related what was done, in the Case of Dr Keil, I hope it may appear, that I have acted an honest, and not an unskilful Part in it: If what was prescribed by others of greater Fame, when it came to be tried, had not better Success, I presume I shall no longer be blamed for it. No Man would willingly lose any Reputation, who is to live by it. I question not, but the best Surgeons in the World will allow, there are Cases for which there is no Remedy: And he who frankly owns thus much, no more loses any Reputation, than the Quack, that promises greater Matters than he afterwards performs, gets any: And I think they, who have censured me, would have done more ingenuously, if they would rather have looked upon the present Case as incurable by any Surgeon, than have thrown their Aspersions upon me, as not treating it properly.

N. B. The foregoing remarkable Case of Dr Keil, was published by Mr Rushworth of Northampton, Surgeon at Oxford, in the Year 1719³. Under the Imprimatur of Robert Shippen, Vice-Can. Oxon.

Some curious Observations made (by my Friend John Ranby, Esq; Surgeon to his Majesty’s Household, and F. R. S.) in the Dissection of Three Subjects, 1728.

THE first, a Man aged 70 Years, who died of a Suppression of Urine, occasioned by a Stone stopping in the Urethra, just within the Glans, of the bigness of a Horse Bean. This Appearance, with the Symptoms that had attended this miserable Man, gave me reason to expect something remarkable in the urinary Passages. The Ureters and Pelvis were very much distended; which is common where great Numbers of Stones have descended down them, from the Kidneys to the Bladder. The Bladder contained about 60 Stones, the largest of which was about the Size of a Walnut, the others smaller; and just within the Neck, was a hard Tumour, as big as a Nutmeg, which almost closed the Orifice: and indeed the Situation of this Tumour was such, that it not only made the passing the Catheter very difficult, and hindered our feeling the Stones, by directing the Instrument upwards: but likewise would alone produce the Symptoms of the Stone in the Bladder, by obstructing the free Discharge of Urine through the Urethra, the inner Membrane of which appeared as if lacerated in several Places, and the Tube filled with a glutinous Matter tinged with Blood. On the back Part of the Vesiculæ Seminales, near the Prostata, were several Stones, as large as Peas, which closely adhered to the adjacent Membranes.