Litholapaxy or rapid lithotrity with evacuation / by Henry J. Bigelow.

  • Bigelow, Henry Jacob, 1818-1890.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Litholapaxy or rapid lithotrity with evacuation / by Henry J. Bigelow. 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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    irritating as litliotrity itself.” (S. D. Gross, Diseases, etc., of the Urinary Organs. Philadelphia, 1876. Page 232.) “Having used it [Clover’s apparatus], very frequently, I would add that it is necessary to use all such apparatus with extreme gentleness, and I prefer to do without it, if possible.” (Sir H. Thompson, Pra'ctical Litliotrity and Lithotomy. 1871. Page 215.) these evacuating catheters are little employed. They re- quire frequent and long manoeuvres, which are not exempt from dangers ; besides, they give passage, as a rule, only to dust, or to little fragments of stone, tvhich would have escaped of them- selves without inconvenience to the urethra.'’’ (Article Lithotritie, by M. Voillemier, Dictionnaire Encyclop^dique des Sciences Mddicales. 1869. Page 733.) • In short, the “evacuating apparatus” and the evacuating method hitherto employed do not evacuate.' This fact is be- yond question. Such apparatus is not of recent contrivance. From the earlier days of lithotrity, the operation of breaking the stone has been followed by the obvious expedient of introducing a large and special catheter, through which water was injected and allowed to escape, bringing away a little sand, with a small fragment or two. This attempt at evacuation was aided by suction. With this object, and before the year 1846, Sir Philip Crampton employed an exhausted glass globe. For the same purpose a syi’inge has been used, or a rubber enema or hydrocele bottle, with which fluid could be also injected and the bladder washed. By entering the. catheter well within the bottle or syringe, fragments were dropped inside the neck, where, lying below the current, they remained when the bottle was again com- pressed. When this neck was made of glass, by Clover, the fragments became visible, as in Crampton’s globe, and to this neat arrangement the accomplished lithotritist. Sir Henry Thompson, refers as Clover’s bottle. But neither the previous practice nor the efficiency of evacuation by suction through a tube had been materiall}’’ advanced. In the mean time the syringe was modified in France by a rack and pinion attached to the piston, so that water could be injected and withdrawn with great force, — a procedure not only useless, but detri- mental to the bladder, if inflamed and thickened.