Lithotomy, its successes and its dangers : being a verbatim report, from shorthand notes, of an inquest held before the City Coroner / with a preface and commentary by a practical surgeon.

  • James Beaney
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Lithotomy, its successes and its dangers : being a verbatim report, from shorthand notes, of an inquest held before the City Coroner / with a preface and commentary by a practical surgeon. 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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    and numerous fragments of stone were found in the bladder. Both ureters and kidneys were highly congested, and two small stones were discovered in the right kidney; no wound or opening into the peritoneal cavity was found, nor was there any injury to the bladder, clearly indi- cating that the operation had been properly performed, and that the peritonitis which existed in the pelvic region was the result of the diffi- culties encountered in extracting an unusually large stone. Dr. Neild believed the cause of death to have been, shock from injuries received during the operation, and consequent inflammation of the bladder, ureters, and kidneys, and their peritoneal coverings. Had he confined himself simply to stating the fact that the man died from peritonitis, it would have been a correct deduction, from the congested and inflamed state of those organs ; but how he could infer that the patient, whom he had never seen during life, died from a shock, is equally as illogical as untrue. In answer to the Coroner he stated, he could not find the mem- braneous portion of the urethra, the prostate gland, or the neck of the bladder, although he searched for them; they appeared to have been removed by violence. According to this statement, they must have been torn out during life, of which fact there is not the slightest evidence ad- duced by any one of the witnesses who were present at the operation. As decomposition of the body was so far advanced, and these soft and injured parts would be the first to decay, it is a very strong assertion to make, with so little to justify it. When cross-examined by Mr. Purves as to whether he, Dr. Neild, might not be fallible as to the cause of Berth’s death, the reply was, “ I speak from what I have seen, and I can only give an opinion from the post mortem appearances.” Now Dr. Neild must be a much greater pathologist than he has the reputation of being, if he could say that there could have been no previous inflammation of the kidneys, either recent or remote, and that their claret-coloured appearance and congestion of their vessels was solely due to inflammation supervening immediately after, and due to the operation. It is admitted there was no organic disease of the kidneys, but there might have been several different attacks of inflammation of these organs, which it would be im- possible either to prove or deny, from the appearance of these organs at the post mortem. Dr. Neild speaks with all the confidence of youth when he says that the cause of death was not a surmise, but a logical conclusion from the facts as presented at the post mortem. Medical men are usually more cautious, and generally tell a jury that there was
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