Lithotrity, and statistics of lithotomy / by George Buchanan.

  • Buchanan, George, 1827-1906.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Lithotrity, and statistics of lithotomy / by George Buchanan. 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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    on a patient in the Royal Infirmary, in July, 1866, with success. My bias to prefer lithotrity when possible, is strengthened by the fact that there are several gentlemen, now well up in years, from whom I have removed calculi by lithotrity with very little trouble or annoyance to them, who are at present in perfect health; but on whom, I confess, I would have performed lithotomy with very great anxiety and fear for the result. So that my own opinion is strongly in favour of lithotrity in favourable cases, and certainly always in the case of stones of small size. Numerically stated, my experience is far too limited to be of much value; still I give it as a contribution. I have performed lithotomy fifty-six times, with eight deaths, or one in seven operated on, a proportion very similar to that obtained by examining tables of lithotomy at all ages, and involving large numbers of operations. But when we separate cases under, from those over, puberty, the contrast is striking. Of the whole number, thirty were over fifteen years of age, and the mortality after lithotomy in them was six, or one in five. There were twenty-six cases under fifteen years of age, and the mortality was two, or one in thirteen. On the other hand, I have had twenty-five cases of lithotrity, most of them in private practice, with three deaths or one in eight. Of these three, one died of apoplexy in twelve hours, some days after the stone was removed. The other two were, I confess, cases which should not have been operated on at all, either by one way or the other; the state of the patient and bladder being very unfavourable for any operative interference. This is just one of the difficulties a surgeon often meets with. His patient has arrived at a stage of suffering when life is insupportable without relief, and he prefers to accept the remotest chance of success, rather than to endure any longer the agony he is undergoing. In such circumstances lithotomy is very likely to be fatal, but if any operation is to be done, it ought to be selected. But these are just some of the cases which in the future will be the subjects of lithotomy, so that in proportion as lithotrity gains ground, and the suitable cases are chosen for it, in the same