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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    Let it be recollected, that the present advocates for the high operation recommend the use of the gorget in the lateral opera- tion. It has been already stated, that it is not surprising that those who imagine the gorget to be the best instrument for performing the lateral operation, should be desirous of giving up the operation altogether; and why, may be discovered by the following list of difficulties and mishaps, some of which every surgeon, who has seen many operations with the gorget, must have witnessed. But in the first place, let us inquire why it is that surgeons prefer the operation with the gorget. Is it not because, having a staff in the bladder, into which they can nicely fit the beak of the gorget, that they think there is no fear of missing the bladder, when they force in the instrument. How often does one hear students say “ the gorget for me; let me get the beak into the groove of the staff, and then I shall cut into the bladder.” This then is the grand secret 3 but is not the surgeon often foiled in his attempt?—that must be granted; and what have the consequences been ? Has not the patient been frequently sent to bed with the conviction, at least the assertion, that there is no stone ? Has not the patient died, and the bladder been found uncut, and the stone lying in it ? Has it not been often, often said that the stone is^sacculated; and upon examination after death the bladder found to be the sac ? Has not a surgeon, determined not to be foiled, brought away the stone surrounded by part of the bladder ? These are but one train of accidents which, to the knowledge of many, have occurred not unfrequcntly within the last ten years. Let us endeavour to give some idea how such accidents may happen. The principal reason is, that the bladder has not been opened, and how does that take place ? 1st. Let any one examine the gorgets in the principal cutler’s shops in London. The beak of the gorget is made very small, and the groove in the staff is made to correspond to it, and this instrument is believed to be good, because the two instruments accurately fit each other. The first objection to the instrument is very obvious, if we recollect the size of the urethra compared to the size of the groove, but in operation ; it is still more so, when we see the difficulty the surgeon has in finding the staff, and cutting into the groove ; how often has a surgeon been seen to any six surgeons in London. VVe dare not state the number that has been given to ui, for it might destroy the credit of the story with many, though we place implicit confidence in the honour of the gentlemen who have reported it to us. But we shall make it our duty to inquire farther into the subject.
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