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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![reduced to smaller portions hy pressure alone; for wliicli purpose it is frequently not even necessary to employ the screw, pushing the ends of the branches against each other with the hand being sufficient, hor this part of the operation, as also for crushing small stones, the screw scoop and catheter forceps, (see l^Iate L Fig. 4 and 5), constructed by Weiss, may often supersede the em- ])loymcnt of the lithotrite. These instruments are also well calcu- lated to remove small fragments or detritus lodged behind the pro- state. Injections of the bladder, cither through the last named instrument, or through a large silver catheter, constructed for the purpose, the eyes of which arc of considerable diameter, will also very much facilitate the expulsion of detritus. In favourable cases, after a sitting of lithotrity, the patient usually experiences some pain or uneasiness for a few hours, or a- day or two, passes a little blood and some fragments or detritus with the urine. He is not necessarily confined to his bed during the treatment, and in many cases may attend to his usual avoca- tions. Some patients have cvcii walked to the operator’s house and home again after the sitting is over, experiencing no' further inconvenience than the passage of a bougie would occasion in others. In most persons the first sittings (supposing several to be necessary) are the most painful and more likely to be followed by unpleasant’consequences, the sidjscquent sittings being generally attended with less inconvenience, as the parts become more accus- tomed to the stimulus of the instrumental manoeuvres, and as the size of the foreign body becomes diminished. In some cases, how- ever, the progress towards a favourable termination is retarded by the occurrence of one or other of the accidents which may ensue during the treatment, rendering the result doubtful, and which at an earlier period was so frequently a cause of failure. I shall here briefly notice the accidents most likely to' occur, even when lithotrity has been properly performed, and in suitable cases. It is not uncommon after a sitting of lithotrity, esj)ecially if it have been too much prolonged, for a degree of inflammation of the urethra, attended with discharge, to occur, as sometimes happens even from the mere ])assage of a bougie or sound. By rest, however, attention to diet, the use of diluents, &c. it mostly subsides in a few days, and is attended with no further inconve- nience than that of occasioning the suspension of the operation. The s;unc may be said of inflammation of the testicles, which also sometimes occurs, especially if they be not properly supported. A slight degree of fever very commonly attends the first sittings of lithotrity, but usually subsides within twenty-four hours. In some instances, however, it may continue for a longer period, and may even run high or assume an intermitting character, being sometimes accompanied with alarming symptoms of nervous irrita-](https://iiif.wellcomecollection.org/image/b22335948_0032.jp2/full/800%2C/0/default.jpg)
