Licence: Public Domain Mark
Credit: Rapid lithotrity with evacuation / by E.L. Keyes. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![[Extracted, from the American Journal of the Medical Sciences for April, 1880.] RAPID LITHOTRITY WITH EVACUATION. By E. L. KEYES, A.M., M.D., ADJUNCT TO THE CHAIR OF SURGERY, BELLEVUE HOSPITAL MEDICAL COLLEGE, SURGEON TO BELLEVUE AND CHARITY HOSPITALS, NEW YORK. This operation, to which its inventor has given the name Litholapaxy, has been sufficiently long before the profession to be tested and to be de- clared a successful procedure. It seems to be upon the eve of general adoption by surgeons in this country and in England, as attested by the comparatively numerous cases reported of late in the journals accompanied by brief remarks, these coming from varied sources. The success of the new departure in vesical surgery is due to the gene- ral acceptance by the profession of the fact that the bladder tolerates pro- longed manipulation kindly if left empty afterwards, a principle worked out and first clearly demonstrated to the world by Prof. Bigelow, to whom certainly belongs the credit. Upon this principle of vesical tolerance, however, the method rests, and not upon any particular instrument or set of instruments,—as witnessed by numerous slight changes already made and possible yet to be made by Prof. Bigelow in his own apparatus, as well as by the fact that a number of other operators have performed the identical operation perfectly well with other instruments. In consideration therefore of these two facts, (1) that the operation seems to be about to fall into the domain of general surgery, and (2) that different surgeons have succeeded well with the operation using indifferent instruments, I look upon it as a duty of any one who has had any con- siderable experience in this method to contribute that experience to the common fund of information now rapidly accumulating, in order that the profession as a whole may profit thereby. Different points in the detail of manipulation and otherwise come up in various cases. These should all be exposed for general comment; for it is out of the sum of these that general laws governing the operation must eventually shape themselves.' It is in this spirit that this paper is now written—to contain all the practical points of experience gained by Dr. Van Buren and myself from contact with the patients upon whose histories it is founded. In these cases we have been constantly associated. It has fallen to my lot to per-](https://iiif.wellcomecollection.org/image/b22458207_0005.jp2/full/800%2C/0/default.jpg)