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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![The coexistence of stone with abscess, ulceration, or fungous growths of the bladder, as evidenced by the general state of the patient’s health, the frequent passage of blood, purulent matter, or portions of fleshy substance with the urine, is generally consi- dered so absolutely to counterindicate any operation, that 1 need not do more than allude to these morbid states. Blood or puru- lent matter in the urine may, however, come from one of the kid- neys, I’rom abscess of the ])rostate, or of the perineum, or from the surface of the urethra, and an operation for the removal of the stone may nevertheless be practicable with advantage. In these cases the surgeon must be guided by the concomitant circumstances in his choice of the method to be adopted. When disease of one or both kidneys is known to exist, few persons would recommend lithotomy, as it would be attended with but slender chances of success, for, even were the patient to sur- vive the operation, the existing disease would in all probability be aggravated, and eause his death at no distant period. In some cases of this description, lithotrity might be had recourse to with advantage, the shock to the constitution being comparatively small, and the irritation from this operation being less likely to extend to the diseased organ. Having thus noticed some of the conditions which appear to in- dicate when one or other of the operations should be preferred, as far as the stone itself and the organs principally implicated are concerned, I must not omit, before concluding, to allude to the state of other organs, and the general condition of the patient, which must often exercise great influence on the choice of the ope- ration, and in enabling the surgeon to rletermine whether cither could be ])erformed with a prospect of advantage. 'Die existence of organic disease of important parts, even when not immediately tending to shorten life, is generally considered a sufficient reason for abstaining from the performance of any seri- ous operation, especially of lithotomy, which, by the shock im- parted to the system, would not fail in most instances to aggravate the existing disease, and even render recovery from the immediate effects of the operation extremely doubtful. Hence many patients with stone who at the same time laboured under chronic disease of the abdominal or thoracic viscera, bronchial irritation, asthma, &C. were, previous to the invention of lithotrity, condemned to retain the stone in their bladder, and to endure the suffering from this disease, without a prospect of its removal. Such persons may now reasonably indulge the hope of a cure by means of lithotrity, with comparatively little risk, when other circumstances admit of its application, as, except where there exists much constitutional or local irritability, the effects of lithotrity are mostly confined to the parts implicated, and are not generally extended to distant or-](https://iiif.wellcomecollection.org/image/b22335948_0049.jp2/full/800%2C/0/default.jpg)
