Licence: Public Domain Mark
Credit: On the causes of death after lithotomy / by Thomas Bryant. 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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![k nd thickened and granular, of a livid and dusky-red colour, with a considerable quantity of adherent coagulable lymph. About the middle of the bladder, and at its side, was a small opening through the muscular coat, which nearly led to the cellular tissue around; it was irregular, with a purulent surface. It had no appearance of having been incised, but it is not im- probable that a small pouch had existed, and that the irritation inseparable from the repeated introduction of the instrument had contributed to effect the opening. The cellular tissue in the pelvis was soft and lacerable, and sprinkled with numerous points in which suppuration was commencing. The other \ viscera were healthy. ost lus led Ite' :ral of Case xxvii.—A man, set. 68, who had been the subject of j stricture for twenty years, and for the last five months had s suffered much from severe bladder-symptoms, after dilatation cof the stricture, was lithotomized, and an oxalate of lime ccalculus coated with phosphates removed. Some slight oozing cof blood followed the operation; but the man never rallied, and sank upon the third day. On necroscopic examination, the kidneys were found to be idegenerated, and the pelvis of the left inflamed. Bladder was thicker than natural; its mucous membrane was of a dark colour and in places sloughing, and adherent to it were patches Df phosphates. The cellular tissue round the bladder and rectum and sides of pelvis, nearly as high as the psoas 1 muscle, was inflamed and suppurating in small points of pus. Wound at neck of bladder was almost sloughing. The urethra showed the appearance of a cured stricture in its spongy portion. The mucous membrane was rough and linelastic at the spot, and covered with old adventitious deposit. The other viscera were healthy, except some senile changes. Case xxviii.—A man, set. 59, after symptoms for six years, .vas operated upon with difficulty as the stone was impacted; much blood was lost at the time; and, fifteen hours after, he : lied rather unexpectedly. After death the heart was found enlarged, and its muscular tissue encroached upon externally by at; the coronary arteries were much diseased, and atheroma ]pon the valves. The kidneys were much diseased, from](https://iiif.wellcomecollection.org/image/b22329286_0013.jp2/full/800%2C/0/default.jpg)
