A stool should be prepared, the patient should be seated on it and a servant should be called; he places his hands under the patient's knees, and then the doctor begins the incision. You must first feel the stone and bring it to the place where you want to make the cut; this is accomplished by inserting the middle finger into the anus of men and girls, and into the mouth of the vagina for women deprived of their virginity. When you find a stone, press it with your other hand from top to bottom from the walls of the abdomen and navel so that the stone goes down closer to the mouth of the bladder. Try to push the stone so that it moves away from the seam to the distance of a barley grain, and beware of cutting at the seam - this is very bad, and the seam, to tell the truth, is a deadly place. When pushing the stone, one must not allow insufficiency, because then the cut will be wide and will not heal. When you push the stone and see that the cut will not be through, make a puncture, if what you have done so far has not led to excruciating pain, bending of the neck of the bladder, loss of strength, cessation of movements and speech and sunken eyes and eyelids, but if it soon came to this - don’t puncture; as soon as you pierce it, the patient will die. Then cut the tissue over the stone slightly obliquely, being careful not to touch the nerves and trying to ensure that the cut falls on the neck of the bladder: if it ends up in the body of the bladder itself, it will not heal at all. Also try to keep the cut as small as possible. If the stone is small, it can sometimes be thrown out by pressing, but with a large stone it is necessary to make a wide cut, and often it is necessary to resort to a hook to pull it out. It happens that the stone turns out to be very large, so it is impossible to make a cut according to its size. In this case, you should grab it with tongs and grind it little by little; what breaks off is taken out, leaving nothing in the bubble, for what remains will begin to grow and enlarge again.
It often happens that a stone appears at the neck of the bladder and in the area adjacent to the penis; then you should, without ceasing to rub your pubis, press on it. There should be an assistant next to you, and when the stone gets stuck in some place, they cut the skin under it and remove it. Sometimes it is good to tie a thread behind the stone so that it does not go back. If the stone comes close to the head of the penis, you should not forcefully remove it through the penis, because this sometimes causes a wound and it does not heal. On the contrary, you must straighten the position of the stone and bandage the penis behind it, and then make an incision above the head of the penis so that the stone comes out. When you do everything that is said about this with the stone, and remove it, tumors often appear from the strong pressure on the stomach and from the pain during the incision, and this is what you should be wary of. One way to eliminate the tumor is to give the patient an enema and remove the feces, and then give him something to soften the nature; Give him little to eat, and only something softening. When it is necessary to bleed to protect against a tumor, then do it. If you want to protect even better, or if signs of a tumor appear and the pain intensifies, then you should put the patient in a bath or in a basin of water in which emollients, for example, Judean mallow, flaxseed, marshmallow, bran, were boiled. And you will first add a lot of oil to this water and mix it with water, which should be lukewarm. And when you take the patient out of the bath, rub his organ on all sides with emollient oils, for example, chamomile or dill oil, and apply it to the wound and pour warmed cow oil into it. On top of the oil, place a piece of cotton paper soaked in rose oil with a little vinegar, and then apply healing medicines.
If the swelling increases, then constantly put the patient in the mentioned bath with a decoction of fenugreek and flaxseed, and if the pain intensifies, put the patient on the second and third day in water with heated oil. And those whose incision and wound do not hurt any significantly are released on the third day. The bladder should be constantly warmed with rue oil; when it is warmed, it is in better condition, hurts less and produces less urine, and urination is very painful for those who have been punctured; for the same reason, the patient should be given only a little water. Whenever the patient urinates, the servant must protect the bandaged area with his hand and press it so that urine does not fall on the incision site. Then the possibility cannot be excluded that either the proper amount of blood will not flow out of the wound, and then one may be afraid of swelling and rotting of the organ, especially if its color turns from red to black, or blood will flow excessively, and then one may be afraid of bleeding. In the first case, as soon as you see the mentioned sign, you should immediately make an incision for treatment to allow blood to flow out, and apply a bandage to the organ with vinegar and salt on a linen rag in order to prevent rotting. In the second case, when blood loss is feared, it is best to put the patient in decoctions of known astringent plants and put crushed incense and vitriol on the bleeding place and on top - a piece of cotton paper, and on this piece - another, large piece of cotton paper soaked in vinegar with water.
If you notice that a large vein or artery has been cut, then use tugging in the treatment: if the blood does not obey and does not stop and the wound does not heal, then put the patient in hot vinegar. Often, to attract blood, it is necessary to do bloodletting, and sometimes it is necessary to apply numbing drugs to the pubis and groins. As a result of the cut and bleeding, it sometimes happens that a blood clot flows into the bladder, solidifies at its mouth and retains urine; then you inevitably have to insert a finger into the puncture, push the harmful clot away from the mouth of the bubble and from its neck and remove it. This area should be treated with vinegar and water so that the frozen clot dissolves and comes out. One of the consequences of the cut may be the cessation of fertility. As for the bad signs, when the doctor appears, he is convinced that the patient will die, they are as follows: the pain under the navel intensifies, the extremities become cold, the fever worsens, chills appear and strength drops. Then, when the pain at the site of the incision sharply intensifies, hiccups and ominous signs begin. twitching of the stomach means death is near. And good signs are when consciousness returns and appetite is corrected, and when the patient has a healthy, good complexion and appearance.