The second case points out, under certain circumstances, the practibility of extracting, by incision into the gall-bladder itself, those _calculi_, which, from their figure, or other impediments, cannot be voided in the natural way. The method of performing this unusual operation, and some instances of its success, have already been made public in the Memoires de l’Acad. de Chirurg. 1. Mrs. F----, a sedentary corpulent old lady, had been much subject to colicky complaints, without jaundice, in the vigour of life. The seat of the pain was chiefly under the right _hypochondrium_, as high as the stomach. She had been tolerably free from it for at least eight years past. December 5, 1753, about eleven o’clock in the evening, she was suddenly seized with a violent pain, extending from that part of the stomach lying under the right side, thro’ to her back. She compared it to a sword driven in that direction. This pain continued not only with unremitted violence, but even increased, till seven o’clock in the morning: all this time she vomited and strained almost incessantly; but after her stomach was emptied of its contents, nothing came up besides clear slime, streaked with blood. About seven o’clock in the morning she felt her pain fall or move lower, as she expressed it, and from that time became remarkably easier. Soon after this change, she became extremely sick, and vomited up, for the first time, a prodigious quantity of greenish yellow bile. She had not before this seizure been remarkably costive; and in her pain had a free motion to stool with effect; but during the remainder of the (6th) day had none, tho’ all this time emollient clysters were injected; and she took regularly every two hours a powder of _magnes. alb. terr. fol. tartar. tart. vitriol. ana_ ℈j. _ol. nuc. mosch. gutt._ j. with a draught of the _succ. limon. & sal. absinth_. But in the middle of the night, and all day (the 7th), she had an abundant discharge of loose bilious stools. She had continued free from excessive pain since the morning of the former day, only now and then complained of uneasiness sometimes in one, sometimes in another, part of her bowels. About twenty-four hours after her first seizure, she felt a great pain striking towards the bottom of her back, and one hour after voided the extraordinary _calculus_, of which the figure and description are subjoined. Some time after pieces of skins were voided by stool, which were evidently of the texture and appearance of the internal villous coat of the intestines and gall-bladder. The above medicines were the only ones she used, by my direction, under her painful complaint, excepting an external fomentation, and bleeding, which the hardness and contractedness of her pulse seemed to require. She was ordered to drink plentifully of thin broths, and other soft diluent liquors. During the course of her disorder she had no appearance of jaundice, nor since; and, considering her years, enjoys at present (Sept.