the bladder. A stone in the bladder occasions very similar symptoms,
together with pain in the peritoneum and pubes, dysuria and strangury,
and sometimes the appearance of blood and flocculi (_trumbos_?)
in the urine. Patients suffering from vesical calculus are always
constipated, and the dysuria may increase to the degree called furia,
a condition not without some danger.

Three things are necessary in the cure of stone, viz., a spare and
simple diet, the use of diuretics and a moderate amount of exercise.
It should, however, be remarked that confirmed stone is rarely or
never cured, except by a surgical operation.... If a boy has a clear
and watery urine after it has been sandy, if he frequently scratches
his foot, has involuntary erections and finally obstruction in
micturition, I say that he has a stone in the neck of his bladder.
If now he be laid upon his back with his feet well elevated, and his
whole body be well shaken, if there is a stone present it is possible
that it may fall to the fundus of the bladder. Afterwards direct
the boy to bear down (_ut exprimat se_) and try to make water. If
this treatment turns out in accordance with your theory, the urine
necessarily escapes and your idea and treatment are confirmed. If,
however, the urine not escape, let the boy be shaken vigorously
a second time. If this too fails and strangury ensues, it will be
necessary to resort to the use of a sound or catheter (_argaliam_),
so that when the stone is pushed away from the neck of the bladder the
passage may be opened and the urine may flow out. It may be possible
too that no stone exists, but the urethra is obstructed or closed
by pure coagulated blood. Perhaps there may have been a wound of the
bladder, although no external haemorrhage has appeared, but the blood
coagulating gradually in the bladder has occasioned an obstruction or
narrowing of the urinary passage. Or possibly the blood from a renal