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The Philosophical transactions of the Royal society of London, from their commencement in 1665, in the year 1800 (Volume 8) online

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times reach us here in Northamptonshire, but seldom further west. — The nights
are for the most part calmer than the days; and the winds seldom settled in their
quarter, or at their strength, till some hours after sun-rise, and generally die
away again before sun-set.



486



PHILOSOPHICAL TRANSACTIONS.



[anno 1741.



On the Case of a poor Woman who had a Foetus in her Abdomen for nine Years,
opened May 6, 1739. By IVilliam Bromfeild,* Surgeon. N° 460, p. 697.

This woman, about 9 years since, was with child, and, at the expiration of
the usual time, was attempted to be delivered. The child was so far advanced
in the passage, that the midwife declared, that in less than 2 minutes the child
would be in the world ; but, on the woman's suddenly turning herself, the child
slipped from the midwife, and could not be found by her again.

Previous to her being pregnant, she had been afflicted with the venereal
disease, and had had a violent discharge of a fetid matter from the uterus, and
was then under the care of Mr. Balgay, surgeon. She had been salivated once
or twice in our hospitals, but to no purpose. After the time of attempting to
deliver her, to the hour of her death, she had prodigious discharges of a fetid
gleet, and frequently indigested matter with blood from the uterus. There
appeared a tumour on the right side, which was moveable to the other, though
its attachment was chiefly to the right. She was troubled with a suppression of
urine, ever since the attempt of delivery, and within the last twelvemonth went
to stool in a cloth insensibly, and what faeces descended into the rectum, were
immediately discharged. She gradually wasted, from a hale lusty woman, till
she was reduced to a mere skeleton.

On opening the body, the omentum was found entirely wasted; the peritonaeum
was greatly inflamed, and adhered to the subjacent tumour, which Mr. B. ex-
pected, not being acquainted with the case, to be a tumour of the same kind
he had before seen, which was chalky; but, on cutting into it, there appeared
the OS frontis, and, on proceeding farther, the arm, leg, and ribs, on the left
side, with some viscid matter in the interstices. It was seemingly contained in
a thick membranous cyst, which, on dissection, proved to be the containing
membranes of the foetus, contracted to the shape of the foetus in utero, and
gave the tumour an oval form. The situation of the foetus was in the concave
part of the right ilium, and by its cyst was attached to the intestines, colon,
and caecum. It had some vessels that ran on the surface of the cyst, that was
sent from the internal iliacs of the contrary side. By its pressure on the righ
ureter, it had hindered the descent of the urine, and had greatly enlarged both
the ureter and pelvis, of the right kidney, which was greatly distended with
urine, so that what descended into the bladder, must steal in by drops.

The uterus and Fallopian tubes appeared of their usual size, only inflamed.

* Mr. Bromfeild was a surgeon of considerable eminence, and author of two volumes of Chi-
rurgical Cases and Observations, and of some other tracts, such as a Treatise on the English Night-
shades ; a pamphlet on the Treatment of Persons under Inoculation, &c. It is said that the Lock-
Hospital was projected by him. Mr. B. was bom in 171-2, and died in 17P2.



VOL.



XLr.] PHILOSOPHICAL TRANSACTIONS. 489



The fimbriae were loose and fluctuating. On examining farther into the pelvis,
there was near 6 oz. of fetid matter, lying between the rectum and uterus,
which near its neck, was perforated, and the parts were very rotten. From its
neck, almost to the extremity of the vaginae, the muscles of the anus were
nearly destroyed. There were some few indurated little tumours adhering
loosely to the cyst of the foetus. There were several little parts appeared like
carious bones found in the matter contained in the pelvis.

A Letter from Mr. John Powell, to Sir Hans Sloane, Bart. Pr. R. S. &c. con-
cerning a Gentlewoman who voided, with her Urine, hairy crustaceous Sub-
stances. To which is annexed Sir Hans Shanes Answer, containing several
Observations of extraordinary Substances voided by the Urinary Passages.
N" 460, p. 699.

A worthy divine's daughter of the neighbourhood of Pembroke, had voided
for nearly 2 years preceding this account, with her urine, various hairy crusta-
ceous substances. She was near 40 years of age, and had been married about
17 years, and had a child about 12 years before, that lived about 9 weeks.

About two years before, she was seized with a stoppage in her urine, a small
pain in her bladder, and a great pain in the bottom of her feet, with the mak-
ing of whitish water like whey ; and she had then a great weakness in her
limbs, and a pain in her bowels; for which a gentleman ordered her to go into
the cold bath, by which she found great benefit for the pains in her limbs ; but
the pain in making water rather increased, and then her urine began to grow
fetid ; and about Christmas 2 years preceding, she voided the largest of the
things in the box ;* without any very great pain then, as she had taken a quiet-
ing draught that night to compose her ; but, almost ever after, they put her
to most exquisite pain before she can get them off; and she was commonly
obliged to take the small part of the hairy part between her fingers, before she
could get them off; and often a good deal of blood came off with her plucking
them, which made her very sore inwardly.

On using gentle evacuations, with emollient decoctions, &c. she got much
better; insomuch, that she undertook a journey into Herefordshire, and staid
there near 2 months ; but her pains became worse, and more troublesome,
after her return home ; and she then voided great quantities of those large sub-
stances, as well as small, contained in the box, and her urine got extraordinarily
ropy and fetid, notwithstanding all the endeavours of another gentleman and
Mr. P. ; and very often the substance she voided would be so stift' and ropy,

• Mr. P. sent a quantity of tlie hairy crustaceous substances, voided by this woman, in a box to
Sir Hans Sloane.

VOL. vm. 3 R



Ago rHILOSOPHICAL TRANSACTIONS. [aNNO 1741.

that they could scarcely separate it from the pot ; at other times so pliant, that
you might take it up a great height with a sprig of a broom, oi- a feather, and
so fall down again like a lump into the pot.

She had for a considerable lime voided one or more of these hairy crustaceous
substances every day or night ; looking, when first voided, like hair and co-
ralline ; and her pains were so exquisite, that they were obliged, every 3d
night at furthest, to give her an anodyne to quiet her ; and that often cannot
be done, her pain being so very great.

The continuance of this severe pain brought her to great weakness, and
almost a total loss of flesh ; and unfortunately milk by no means agreed with
her. She often tried to conquer it, but never could, it constantly making her
very sick in her stomach, and she vomited it up in large lumps.

They used injections of 2 or 3 sorts, but she could not well bear them ; she
had her menses very regularly, till within the 2 or 3 last times : and for 10 or
12 days before this account was sent, she had complained of a swelling in her
belly, but none in her thighs nor legs.

She often found a crepitus, or a breaking of wind, as it were, in her bladder;
which would make one believe, that there was an aperture from the intestinum
rectum to the bladder. Her bladder has been searched, but the surgeon could
discover no stone.

She had for 4 or 5 days preceding this account, complained, at times, of
asthmatic fits, which were attributed to the heat of the weather. The voiding
of these hairy crustaceous substances never occurred to him before ; though
more than once he had had persons who voided large bladders^ like the hydatids
in fish, in large quantities, and had cured them.

She drank the hot-well waters both at Bristol and here, but with little suc-
cess ; and took cantharides inwardly, as prescribed by Dr. Groenvelt, in ulcers
of the bladder, and all other things that Mr. P. could think of.

Sir Ham Shanes Answer to Mr. Powell, p. 703.

In this reply, Sir H. S. states, that he is persuaded that the hairy excretions
were generated in her kidneys. He had seen, in his practice, some instances of
the like, and had by him what was brought off by urine from some of them.
The first he remembered, was from a gentleman near the Exchange, who would
frequently, 40 years since, void with his urine long hairs, which were received
on white paper ; and, by their transparency and angles, yielded, on viewing by
a microscope, the finest colours imaginable, such as we find by a prism. This
gentleman did not suffer much, though he complained of a sharpness of urine.
The person who was affected the most, was a brewer, who had such hairs



»



VOL. XLI.] PHILOSOPHICAL TRANSACTIONS. 4^1

matted or woven together, voided by urine with great pain ; but then there was
no calculous matter, or very little, added to them. It is very likely, that that
matter is added to those of your patient in the bladder, by being retained there.
He had a pin, that a young woman had swallowed, and was afterwards taken
out of her groin from an apostem after a tumour ; which pin was covered or
incrusted, as these hairy substances, with such calculous matter, and got there
from the urine in her bladder, where in all likelihood it had contracted that
crust. He had a silver bodkin, the broad end of which is covered with a pretty
large stone. A poor gentlewoman thought, by thrusting this bodkin up the
meatus urinarius, to remove a stone which pressed on the neck of her bladder,
and it slipped past recovery into her bladder ; whence, after 3 years, it was
taken, and on which, as on a centre, was bred the stone. He had other in-
stances of the same, where an extraneous body, passed into the bladder, has
proved as a centre to attract, or have affixed to it, such matter.

As to the cure, dilution seemed to him the best. The brewer was cured by
drinking plentifully of soft liquors, which he often poured down ; and twice a
week he took the purging waters. His opinion was, that the less is generated
of this matter, and the less time it remains in either kidneys, ureters, or blad-
der, the disease will be mitigated, and, he hoped, cured. He believed Bath-
waters drank warm, mallow-tea, linseed-tea, oil of sweet almonds, syrup of
marshmallows, little and often taken, with baths of emollient herbs, might be
of great use ; and perhaps moderate exercise might help them off. Opiates, in
excessive pain, he judged necessary; and now and then bleeding, to take off
the inflammations that must of necessity attend such a distemper. He also
thought, that some balsamics, such as Locatelli's balsam, might be useful ; and
perhaps, with the emollient method, take off that disposition in the kidneys,
which produced this uncommon distemper. The pains in her feet, and about
her, seemed not to have any relation to this distemper ; and he was of opinion,
that violent diuretics or exercise would rather hurt than help her.

^ Letter from Mr. T. Knight to Sir Hans Sloane, Bart. Pr. R. S. fife, con-
cerning Hair voided by Urine. N° 460, p. 705.

The hairy substance, or fine capillamenta, inclosed in the pill-box, were dis-
charged along with the urine of a gentleman, during a severe fit of ardor urinae ;
the gravel that came away was inconsiderable, so that the cause of the dysury
was chiefly owing to the hairy substance with the gritty matter that adheres to
it, inflaming, by their irritations, the ureters and sphincter vesicae, and parts
adjacent. For, notwithstanding phlebotomy, lenient clysters, emulsions,

3r 2



4^2 PHILOSOPHICAL TRANSACTrONS, [aNNOJ741.

opiates, and such like remedies, were strictly used, all proved ineffectual, till
all this extraneous substance was come away.

These fine capillamenta seem to be the tegument of an animal, which had
got into the primae vise, and passed the venae lacteae, and, by circulation,
passed also the glandulae renales. For it is more probable, that they were ex-
traneous, than that they were generated in the urinary passages, in an equivo-
cal manner.

The greatest objection, that offered to him was, that it was judged abso-
lutely necessary, that the venae lacteae should be smaller than the finest artery
in the body, that nothing might enter, which might stop circulation of the
blood. Also, that the mouths of the lacteals, which are open into the cavity
of the intestines, from whence they receive their chyle, are so small as not to
be seen by the best microscope in dead bodies.

To obviate these objections, may not the mouths of the lacteals be percep-
tible in living bodies, when dilated, distended, and turgid with chyle ? And
may not these capillamenta, when relaxed with any humidity, become very
flexible, pliable, and susceptible of being contorted, and of assuming any
figure ;* and, when thoroughly relaxed, disseminated and floating in a fluid,
enter the lacteals ; and consequently may pass through the convolution of small
arteries, whereof the glands and secretory vessels are formed ; for a gland is
said to be nothing else but a convolution of small arteries.

N. B. This gentleman has kept a strict regimen of diet for many years, being
subject to frequent fits of the gout, an incontinency of urine, &c. In the
morning early, a draught of cow's milk, statim ab ubere ; which often does not
pass a colatorium, whereby some of the downy hair about the udder might get
along with the milk into the primae viae.

Concerning a large Quantity of Matter or Water contained in Cystises or
Bags adhering to the Peritonaum, and not communicating with the Cavity of
the Abdomen. By Walter Graham, M.D. Mansfield. N" 460, p. 708.

In the middle of Feb. 1735, Jane Dawson, of Mansfield, in Nottingham-
shire, an unmarried woman, aged 30, received a violent strain by lifting a tub
of water, and immediately complained of great pain in her left side. In March
following, she found a lump, or little round swelling, in that side of lier belly ;

• The capillamenta, whilst in the urinal, and till the urine was decanted, appeared only like a
gross turbid liquor, the filaments being so diffused. — Orig.

Dr. Mortimer remarks, in a note, that he doubted of these substances being real hairs; he ima-
gined they were rather slender grumous concretions, formed only in the kidneys by being squeezed
out of the excretory ducts into the pelvis. — Orig.



VOL. XLI.] PHILOSOPHICAL TRANSACTIONS. 493

and soon after the whole abdomen swelled, but more in the left than in the
right side. She complained frequently of severe pains in her bowels, which
in time became so violent, that she had neither ease nor sleep, but by taking
large quantities of opium. During her illness, she made very little urine, and
was so costive, that she had seldom any stools but by the help of purges or
clysters : the former gave her always pain, and the greatest relief she found
was from emollient clysters that emptied the intestines. Her thighs and legs,
were not swelled, but these and other parts of the body were much emaciated.
In this unhappy condition the poor woman lived about 2 years Q months, and
died on the 17th of November. Dr. G. adds, that before this accident of the
strain, she had always enjoyed a tolerable good share of health ; and seldom
made any complaint, but of missing her menstrua.

On viewing the naked body, the abdomen was vastly distended, and most at
the navel. The swelling was unequal, the left side being more swelled than
the right ; and there appeared a very distinct protuberance all along the left epi-
gastrium : this protuberance was much softer than the other parts of the belly,
which were so hard, that on pressure, they did not pit.

On opening the body, the following observations were made :
The membrana adiposa was very thin, and the abdominal muscles were much
extenuated by the great distention, as is usual in like cases.

The peritonaeum, which was the chief seat of the distemper, and the princi-
pal part to be taken notice of, was grown to so monstrous a thickness, that its
section at the navel was 5 inches and -rV ths ; and it was of the same thickness
below, but somewhat thinner above it. All over the peritonaeum, and through-
out the whole, there appeared a prodigious number of glands ; and the space
between one gland and another was filled with a white spongy flesh. Some of
these glands were round, others oblong ; many of them were as large as a
goose's egg, others about the size of a pigeon's egg, and some less ; the largest
being on the left side. Their internal substance was destroyed, and only the
external membranes left, whose cavities were full of liquors of different colours
and consistence : some contained a thin whitish humour, others a pellucid
viscous gelly, like the white of an egg, and some a white thick matter, like
pus. As the contents of these glands thus differed, so did their membranes ;
some were very thin, others thicker, and many of them were become cartila-
ginous. In general, those having thin membranes, contained a thin whitish
liquor ; and those that were cartilaginous, a thick white matter like pus. Their
internal surface was quite smooth, and none of their cavities had any communi-
cation with each other ; nor could the matter be pressed out, without opening
them with a knife.



494 PHILOSOPHICAL TRANSACTIONS. [aNNO 1741.

The protuberance of the left epigastrium, was occasioned by a quantity of
liquor lodged in a cavity formed by the peritonaeum, which in this place was
about T^ths of an inch thick. This cavity extended over the kidney and
spleen, and there was found in it above 2 quarts of thin liquor of a darkish
colour. The whole quantity of matter taken out of that cavity, and those of
the glands which were opened, was about 4 gallons.

In the cavity of the abdomen there was found no matter, or water.

The omentum was very white, and much decayed.

The coats of the stomach and intestines were very thin and tender, and in
flamed in several places. The intestines lay in the right side, and were filled
with hard excrements, forced into that situation by the large protuberance on
the left.

The liver was very large, of a colour more red than common, and full of
blood, which on the smallest incision flowed freely out of it ; and the greatest
part of the blood in the whole body seemed to be accumulated in this viscus,
and was of a darker red colour than usual.

The gall-bladder was not larger than natural, nor did it contain any stones,
or concreted matter ; and, on gentle pressure, the bile moved easily through
the ductus cysticus.

The pancreas was smaller than common, and adhered closely to the duo-
denum .

The kidneys were a little inflamed, and of a flatter figure than usual; occa-
sioned probably by the pressure of the peritonaeum.

The cavity of the thorax was greatly lessened by the diaphragma being
pressed upwards, by which the lungs were likewise much compressed, and they
adhered in several places to the pleura and mediastinum. The heart was of a
paler colour than common : from the middle to its apex, it was pressed flat,
and little or no water was found in the pericardium.

On Hydatids voided per Faginam. By Mr. William Watson, F. R. S.

N''46o, p. 711.

A gentlewoman, aged about 48, the mother of many children, after a respite
of 6 years, had, in Nov. 1739, the symptoms of conception, which left her in
February ; from which time to the end of March, she every night discharged
per vaginam uteri a considerable quantity of blood ; and, not perceiving an in-
crease in her belly, nor (which in cases of conception is the pathognomonic
sign of something preternatural) her breasts, she concluded her menses were
leaving her at their usual period. But, on the first of April, being taken with.



VOL. XLI.J PHILOSOPHICAL TRANSACTIONS. 4Q5

great pains in her back, and having other symptoms antecedent to delivery,
there came away at short intervals, a very large number of hydatids, of all
the intermediate sizes, from a nutmeg to a pin's head, some filled with clear,
others with bloody lymph ; all of them propagated in the manner of a cluster
of grapes from a spongeous substance, answering the purposes of a placenta.
After the discharge of these, in a few days she recovered her accustomed
health.

On boiling some of these hydatids, they appeared like the ovary of a boiled
hen, with this difference ; in the hen, the contents of the ova concrete ; in this
case, not ; but the transparency was changed to the colour of bile diluted
with water.

Tzvo Medico- Chirurgical Observations. By M. Le Cat. N° 46o, p. 712.

1 . An Observation on Hydatids, ivith Conjectures on their Formation.

Sept. 21, 1739, a woman died in our Hotel-Dieu, who had an abscess in
the right hypochondrium, through which she discharged hydatids ; with a
considerable tumour at the left hypochondrium.

Her body was opened. The abscess of the right hypochondrium was be-
tween the proper and common membrane of the liver. The tumour on the
left side was almost as thick as one's head, and twice as long. It was between
the common and proper membrane of the spleen. It ran between the floating
parts of the abdomen ; had displaced them ; and went so far as to push against
the integuments of the belly, in its passage adhering to the stomach.

M. Le C. laid this tumoiy> open, and found it filled with hydatids of all
sizes, with clear water, and mucilaginous membranes, which were the remains
of large hydatids, that were burst by the motions of the patient. He examined
with care both the hydatids, and their bag. The hydatids were composed of
1 mucilaginous, transparent, and yet very elastic membranes. The inner mem-
brane had on its concave surface a sort of villosity wrinkled and mamillated,
that pretty much resembled the surface of a rough skin, or what is called a
goose's skin. The softest and most gelatinous of these membranes, were very
like the vitreous humour of the eye. The water contained in all these hyda. •
tids, was entirely like the aqueous humour of the eyes.

There were clusters of these hydatids quite resembling the ovary of a hen,
or a bunch of grapes, which were made up of globules of all sizes. The bag
that contained them was pretty smooth on the side opposite to the spleen ; that
is, that part of the bag formed by the common membrane of the spleen, or by
the peritonaeum, was pretty smooth ; but on the side next the spleen, the



4Q6 philosophical transactions. [anno 1741.

bottom of the bag was very thick, and composed of several lamellae half de-
stroyed, which fell off in bits or scales, and in slime, at the least touch.

It appeared plainly on the inspection of these remains of the bottom of the
bag, that that was the source of the hydatids ; and, on considering what sort
of parts are found on the surface of the viscera, under their integuments, it
seems evident, that these lymphatic globules were nothing else but the glandu-
lousand lymphatic grains of the surface of the spleen, dilated into excrescences
by the disease, and puffed up by the lymph, which the distemper caused to ac-
cumulate there.

He had proved, in his Physiology, then in the press, that these glandulous
grains are nothing but the ends of the nerves, or nervous papillae, which receive
the ends of the lymphatic vessels into their spongy texture : and he had, among
others, instanced in the papillae of the tongue, called glandulous papillae, which
are at the same time the organ of taste,* and the receptacle of the salival
lymph.

A part of the nerves, which are distributed into the substance of the liver
and spleen, terminate in the surface of those viscera, under the form of glan-
dulous or pulpous grains. This same surface is the seat of a great number of
those lymphatic vessels. And it is not to be doubted but those glandulous grains
are as necessary for those lymphatics, as the parotid gland is necessary for the
lymph of the salival duct, and the glandulous papillae of the tongue for the liquor
that distils from them. In quality of glands, they are the receptacle of those
liquors : as nervous papillae, they furnish the spirits necessary for the functions
of those liquors. All these truths are proved in the work, above cited. Let us
now come to the consequences of this structure.

As long as the glandulous papillae are sound, their excretory pores pour
forth the lymph according as their cavities receive it from the lymphatics ; but



Online LibraryRoyal Society (Great Britain)The Philosophical transactions of the Royal society of London, from their commencement in 1665, in the year 1800 (Volume 8) → online text (page 57 of 85)