A treatise on the formation, constituents, and extraction of the urinary calculus. Being the essay for which the Jacksonian prize for the year 1833 was awarded by the Royal College of Surgeons in London / by John Green Crosse.

  • Cross, John, 1790-1850.
Date:
1841
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the formation, constituents, and extraction of the urinary calculus. Being the essay for which the Jacksonian prize for the year 1833 was awarded by the Royal College of Surgeons in London / by John Green Crosse. Source: Wellcome Collection.

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    nation, that the enlarged prostate gland was the first disease present, the urethral stricture, stone, and morbid condition of bladder, ureters, and kidney, all resulting from it. Plates ix and xv are further illustrations of stone in the bladder, from an enlarged prostrate gland. Hernial displacement of the bladder,3 sacculi formed by its inner membrane passing between the fibres of the muscular coat, and prolapsus of the organ (which 3 Cystocele disposes strongly to the formation of an urinary calculus, and in all the various situa- tions in which this species of hernia has been found, as inguinal, femoral, ventral, ischiatic, puden- dal, and perinaeal, a stone may be met with. Schreger describes a cystocele at the ischiatic notch, forming an external tumour, which, being not understood, was opened or cut off. (Chirurgische Versuche, b. 2.) The least rare is cystocele at the groin, descending into the scrotum. Plater opened such a hernia by mistake, the urine flowing through the orifice at the groin. In a similar case, an ignoramus mistook such a swelling for an abscess, and made an opening into the protruded bladder, which Guyon succeeded in healing, keeping a catheter in the urethra. Bartholin (Hist. Anat. Gent. iv, 28,) sounded a man without feeling a stone; but found one on dissection, in a part of the bladder, prolapsed a't the groin into the scrotum: the reported instances of calculi discharged at the groin are explainable by such cases. In a vesical hernia reaching into the scrotum, Petit le Pkre felt several small calculi. The most interesting case of cystocele at the groin, opened by mistake, is given by Pott, in Philosophical Transactions for 1764, and to be found in his works, by Earle, vol. iii, p. 323. Beaumont, by placing a truss on a hernia of the bladder at the groin, containing a calculus, caused the death of the patient. Verdier (Recherch.es sur la Hernie de la Vessie, in Mem. de VAcad, de Chi- rurgie, tom. ii, p. 7) found four calculi as big as a small chesnut in a hernia of the bladder at the groin; and relates a similar case, where the tumor was opened by caustic, (p. 10.) Besides the excellent Memoir of Verdier, see Divoux, Diss. Medico-chirurgica de Hernia Vesica Urinaria, in Halleri Disp. Chir. tom. iii, p. 271. A case of inguinal cystocele, with calculi, is related in Edinb. Med. and Surg. Journal, vol. xiv, p. 141. Boyer treats at length upon cystocele, and remarks that a calculus may fill up the isthmus between the hernial and pelvic portion of the vesical cavity, so as to interrupt the diag- nosis. (Maladies Chirurgicales, tom. viii, p. 360.) Calculi occurring in a hernial or prolapsed part of the bladder, can only be detected by the touch, and when the tumour presents itself externally ; the rarity of their occurrence is scarcely to be urged as a reason for not attending to them, considering that in a majority of recorded cases they have been overlooked or misunderstood. Their prevention depends upon treating the cystocele by a truss, and when formed, they should not be pressed into the general cavity of the bladder, but removed by a direct opening in the situation of the tumour, an operation presenting little difficulty or danger, as the bladder does not carry the peritonaeum before it, has no hernial sac, and does not interest the peritoneum, unless complicated by an enterocele; (for the anatomy of cys- tocele under this complication, see Sir A. Cooper on Hernia, edited by Mr. Key, part ii, p. 63.) The urine should be conducted off by a catheter, the patient lying on the side opposite to the disease, and no attempt made to return or compress the hernial tumour, until the opening into the bladder is healed.