On the comparative advantages of lithotomy and lithotrity : and on the circumstances under which one method should be preferred to the other : being the dissertation for which the Jacksonian Prize for 1838 was awarded / to Edwin Lee.
- Lee, Edwin, -1870.
- Date:
- [1842]
Licence: Public Domain Mark
Credit: On the comparative advantages of lithotomy and lithotrity : and on the circumstances under which one method should be preferred to the other : being the dissertation for which the Jacksonian Prize for 1838 was awarded / to Edwin Lee. 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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![tlic other, 80 as to allow a separation between the extremities about three inches in extent. 'I'lie teeth arc very large, aiul on the same level on each branch, from which it results that the in- tervening spaces arc considerably w'cakcr. .'I’he more modern in- struments, however, arc muchsnmllcr in diameter, combine strength with lightness, and the arrangement of the teeth is such as to af- ford an equal degree of strength throughout. A percussor with - out teeth is also not unfrcqucntly employed by Baron Jleurtelou]), especially when attacking small calculi or fragments. A part of the apparatus formerly considered indispensable for this operation, is the rectangular bed, proposed by the Baron, by means of which the patient’s ])elvis may be raised above the level of his shoulders, in order that the stone may fall by its own weight to the most favourable part of the bladder for being seized. After the stone is in the grasp of the percussor, the bed also serves to fix the instrument firmly, and thus prevent the shock of the blows from the hammer from affecting the parictes of the bladder. This is elFccted by an iron appendage fixed to the end of the bed, the branches of which being approximated by a screw, hold the percus- sor between them, as in a vice. In performing the operation, the patient is fixed upon the bed in a j)roper position, and a moderate quantity of fluid is injected through a silver catheter into the bladder. The percussor is then introduced, and the stone seized. The instrument is then fixed to the bed, and the operator holding it in his left hand, strikes its extremity with a small hammer, till the stone is felt to be broken, when the percussor is removed from the vice in order to take up the fragments, which arc broken in a similar manner, either during the same or at subsequent sittings. The rectangular bed is, however, at present scarcely ever used, exce])t by the Baron himself, as its disadvantages were found by others to more than counterbalance its supposed advantages. Not to speak of the impossibility of obtaining it, except in large towns, and of the inconvenience of having a similar piece of furniture transported to the residence of patients, it tends to complicate the operation, and would in many eases, by its formidable appear- ance, have a most prejudicial effect on the patient's morale. It lias, moreover, the serious disadvantage of being liable to cause injury to the bladder, cither by the movements of the patient, or by the contraction of this organ forcing its parietes against the ex- tremity of the instrument, which, when fixed to the bed, cannot of course yield. In fact, in such a ease, the patient is as it were hooked on to the operating table by his bladder ; and though those who advocate this method of operating represent In engravings the extremity of the percussor holding the stone in the bladder, in the centre of the fluid that has been injected, and consequently](https://iiif.wellcomecollection.org/image/b22335948_0028.jp2/full/800%2C/0/default.jpg)
