A case of vaginal lithotomy : with remarks on stone in the female as it occurs at the Norfolk and Norwich Hospital ... [and 3 other papers] / by Charles Williams.

  • Williams, Charles, 1827-1907
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A case of vaginal lithotomy : with remarks on stone in the female as it occurs at the Norfolk and Norwich Hospital ... [and 3 other papers] / by Charles Williams. 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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    with the forceps occasioned severe straining); the blades could not be made to grip the calculus; they continually slipped off, bringing away pieces of the stone. At last it became absolutely necessary to ascertain what occasioned the difficulty. For this purpose the urethra was still further dilated, and the neck of the bladder was also divided with a probe-pointed bistoury. The stone could now be felt with the point of the finger immovably fixed in the floor of the bladder on the patient’s left. It appeared to be the size of a pigeon’s egg, and was enclosed in a sac, through the neck of which a small portion protruded into the vesical cavity, and it was off this nodule that the forceps so con- tinuously slipped. Many efforts were made to dislodge it— first with a scoop, then with the finger, which could barely reach it, and next with the forceps ; they all proved un- successful. Several portions were broken off the uncovered portion, but the main piece was left in situ, as it was con- sidered undesirable to make any further attempt to remove it, the patient having been a long time under the influence of chloroform and apparently in a very exhausted con- dition. The next day the child had voided very little urine. A catheter was introduced, and a small quantity of sanguineous urine flowed out. She was very drowsy, and had been so since the operation. When roused she took milk and brandy very freely, but immediately aftewards became drowsy again ; she did not appear to have recovered from the influence of the chloroform. The next day she died. No post-mortem examination was permitted. I am induced to believe this child died of chronic chloro- form-poisoning, and not from the effects of the operation, which was by no means roughly performed, and there was very little blood lost. She never thoroughly revived, but became comatose, and died in that condition. It is difficult to imagine what could have given rise to the formation of the sac ; there never was an obstruction to the escape of the urine, such as stricture or prostatic enlargement might engender for neither existed. We arc taught that a cyst is
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