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A man aged 64, who has lived temperately and usually
enjoyed good health; has a frequent inclination to make
water which he passes in drops with much difficulty
and with pain about the neck of his bladder. The Urine
is always muddy; and always mixed with more or less of
a viscid transparent matter, not unlike the white of an
egg: according as the quantity of this matter is greater
or smaller, he passes his urine with more or less pain
and difficulty. Feels ↑frequently↑ pain internally on the left side of
the os coccyges, about its middle; but does not feel any
pain on pressing against the neck of the bladder outwardly
with the finger, nor on pressing the [region?] of the bladder
above the osia pubis. Has also an uneasiness or
sickness at his stomach which causes him to vomit
as often as he takes food; but after he has thrown that
up, he never vomits again till he taken some more food.
Is much troubled with flatulence of his stomach.

The inclination to make water frequently, and the pain
attending it, came on about 5 months ago, but he says that
about 6 years ago after hard riding on horseback he felt a
violent pain of his kidneys, thought he could perceive
something pass gradually down from thence into his
bladder; at that time he voided a considerable quantity
of blood with his urine; but after a few days continuance
this symptom together with the pain of the kidneys went
off. At different times since that period he passed his urine
of a deep red colour, espcially after hard riding & then
attended with more or less pain in the kidneys; this urine
he

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generally passed with some difficulty; but never could per¬
ceive any sand or calculous matter in his urine tho' he obsev¬
ved it diligently. About eight days after the attack of his
present disorder i.e. of the inclination to make water frequently
attended with pain, he first observed the viscid matter mixed with
his urine: and about 6 weeks after the above period he was [seized?]
with the uneasiness and disorder of his stomach: this he [imputes?]
to his having taken 3 oz of Jesuits bark in powder mixed with
3 bottles of Port wine: every dose of which produced a new
uneasiness of his stomach, till at last a vomiting was
produced, by which {illeg} (see)mingly the whole bark was thrown up
that had been taken during a fortnight before. Within a few
days after he took two vomits, and in a few days after [these?]
two doses of Hiera picra successively but the vomiting grew
rather worse than better after these medicines and the other
complaints were not in the least alleviated by them. Has
been bled 3 times; and has at present two blisters open which
discharge plentifully; the one of his leg the other on his arm,
they were applied 8 days ago; but he has received no benefit
from either these or from the bleedings. Belly always regular
skin cool. Pulse 80 rather full; strength is somewhat (↑a good deal↑) impaired tho
not much exhausted: can bear motion even on horseback
without being worse of it; but this is only when the motion
is gentle. - Has been sounded, but no stone was felt.
never has any shivering fits nor sweating fits - is at present
drinking off bitters infused in brandy.

✍ Catarrhus Vesicӕ
from Mr B Bell
Aug 3 1779 V.X. p.55