An inquiry into the present methods of performing the operation of lithotomy.

  • John Shaw
Date:
1821
Catalogue details

Licence: Public Domain Mark

Credit: An inquiry into the present methods of performing the operation of lithotomy. 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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    We shall only give one other striking instance of the ana- tomy :—“ Hemorrhage,—a branch of the internal pudical ar- tery, which is ramified upon the prostate, and the ramifica- tions of which are as various as those of an oak, is frequently divided by the gorget, the bistoure-cachee, and the knife; and I have known several patients die of the division of this artery.” In a foot-note he says, a branch of this artery is sometimes wounded on withdrawing the gorget.” In our dissections, which we may number at some hundreds, excepting once or twice, we never saw an arteiy of any importance on the prostate gland ; that is, they were very numerous and small, and these we know are not the arteries to cause a dangerous bleeding. We have found, in two or three instances, the pudica com- munis pass along the prostate; and Dr. Barclay, who has col- lected every fiict relating to the variety of arteries, mentions only three instances of this kind. Is it probable that the “ several patients,” whom the author has known to die in con- sequence of the division of this artery, had the misfortune to have both stone, and this very unusual distribution of the arteries ? Is it not more probable that if the patients did die of hemorrhage, that it was in consequence of the pudica communis being cut, either in the forcing in, or in the withdrawing of the gorget ? This we suppose must be the vessel the author means, 1 when he says, “ a branch of this artery is sometimes w'ounded on withdrawing the gorget.” The whole contents of the book have such an air of honesty, that Ave are perfectly satisfied the author supposed he was correct ■. in what he Avrote, and we believe that he has seen vessels of a very considerable size on the prostate, but that the vessels he saw were A'cins, not arteries; and he has probably been led into ; this mistake in consequence of using the glue injection, which all those accustomed to make preparations, know, finds a very easy passage into the veins. “ In the course of my dissections and demonstrations I beg leave to observe, that I have been in y the habit of injecting with glue, for a number of years, every subject that I have dissected. ” —p. 151. We shall not here enter farther on the anatomy, we shall only remark, if this author believes that the danger of hemorrhage is ; from cutting the prostate, (p. 150.) what are we to think of the Avonderful escape of the thousands who have had it cut ? | Let us now examine how far the reasoning of the same autho- | rity w'ould induce us to perform the high operation. We shall ] not argue fully upon the whole advantages, w'hich he enumerates 1
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