Quarterly report of the Edinburgh Surgical Hospital, from November 1829 to February 1830 / by James Syme.

  • James Syme
Date:
[1830]
Catalogue details

Licence: Public Domain Mark

Credit: Quarterly report of the Edinburgh Surgical Hospital, from November 1829 to February 1830 / by James Syme. 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.

    13/31 (page 12)
    through tlie fistula into the vagina, not only rendered her ex- istence still more wretched, but made her an insufferable nui- sance to others. Lithotomy.—In the beginning of December Mr Moir asked me to see a boy, three years of age, who, ever since he was eight months old, had suffered the most excruciating distress in making water, which he nevertheless had almost incessant desire to do. His complaints had at first been attributed to the irritation of teething, then to that of worms; and about eight months previous to the time when I saw him he had been sounded for stone. The symptoms were now so strongly in- dicative of calculus in the bladder, that, though none had been detected on the former occasion, I thought it right to introduce a steel bougie, and very soon ascertained the presence of a stone. In performing the operation I encountered a difficulty wliich is frequently met with in young subjects, but rarely, I believe, to such an extent,—I mean a prolapsus of the gut. The intestine was almost constantly protruded; but when the child suffered from the irritation of making water, or the introduction of a staff, it descended so as to form a tumour not less than a goose’s egg, which occupied all the space between the tuberosi- ties of the ischiu;n, and seemed to leave no room for performing the operation. Finding it impossible to keep the intestine reduced, I held it as far as possible aside, and cut very carefully, so as to avoid any injury of it on the one hand, or of the pudic artery on the other. The difficulty was by no means so great as I anticipat- ed, and I readily extracted, in the course of a minute or two, an oval calculus about the size of an almond with the shell. To pre- -vent any risk from infiltration of urine, I introduced a caout- chouc tube. The boy never had a bad symptom, and made all his water through the urethra on the tenth day. Angus Sinclair, act. 77, presented himself at the Hospital 21 St December, labouring under symptoms which led me im- mediately to sound him, when I readily discovered the presence of a stone. As the patient, though old, was not petrticularly weak, or otherwise unfavourably dis])osed for an operation, I performed it on the 23d. Having extracted one small stone, I was led to suspect the existence of others by its angular shape, and after some search detected five more; a tube being then placed in the wound, the patient was conveyed to bed. He seemed to suffer very little during the operation, which would have been completed in considerably less than a minute if it had not been for the number of stones. The urine flowed freely from the tube, which was withdrawn tw'o days after the operation ; and the patient made no coin-