The modern treatment of stone in the bladder by litholapaxy ... / by P.J. Freyer.
- Freyer, Peter J. (Peter Johnston), Sir, 1851-1921.
- Date:
- 1886
Licence: Public Domain Mark
Credit: The modern treatment of stone in the bladder by litholapaxy ... / by P.J. Freyer. Source: Wellcome Collection.
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![question was, after all, not a very unnatural one for a ]nan who had never previously seen a larger ca.theter than No. 12, Certainly, had he seen the imaginary canuloe Nos, 25 to 30 above ascribed to Bigelow the remark would have been a very natural one. In the whole history of surgery I suppose there has been no operation, involving, as this does, one of the greatest improvements ever introduced into operative surgery, that has met with so much adverse criticism and misrej^resentation as Bigelow’s. Out here in India I have seen instruments which are a gross libel on the originator of the operation. Some instrument-makers are in the habit of sending out the apj)aratus with canulm Nos. 18 and 20 only, as if catheters of this size alone were used ; the fact being that they were recom- mended in exceptional cases only. As a rule, there is little or no loss of blood attendino: the operation, with the exception of the trifling bleed- ing that follows the incision in the floor of the urethra where this is necessary to enlarge the meatus. I have frequently removed very large calculi with scarcely a tinge of blood in the washings from beginning to end. In some cases, however, the mucous membrane of the urethra is highly sensitive to the passage of instruments, and considerable bleeding takes place. In such cases I am in the habit of using a weak astringent in the washings, say, \ grain of acetate of lead to the ounce, and winding up the proceedings with a stronger solution (one grain to the ounce). The operation being now completed, the patient should be put to bed, and well wrapt up in warm](https://iiif.wellcomecollection.org/image/b28710307_0061.jp2/full/800%2C/0/default.jpg)
