Case of removal of stone from the bladder by the new operation of lithectasy or cystectasy, with remarks / by Thomas Elliot.

  • Elliot, Thomas, M.R.C.S.L.
Date:
[1842]
Catalogue details

Licence: Public Domain Mark

Credit: Case of removal of stone from the bladder by the new operation of lithectasy or cystectasy, with remarks / by Thomas Elliot. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    was- passed along without any difficulty. A little warm gum-mu- cilaf^e was next slowly injected into tlie instrument, until the pa- tient slightly complained of the feeling of distention. On remov- ing hinffrom the table to the bed he complained of a strong in- clination to make water, which was found to arise from the dilat- ing part of the instrument having slipped into the bladder. It was emptied, partially withdrawn, and, when fairly within the neck of the bladder, again distended. In this position it was secured by attaching a long tape to it, and around the patient's foot, whicli again was fastened to the bed post. The patient did not complain above his breath during the ope- ration, nor lose more than two or three drachms of blood. Ano- ther opiate was now administered. In three hours time, a few teaspoonfuls of the mucilage were again thrown into the dilator until the patient complained. Urine had passed freely along that part of the tube which communicated with the bladder. He slept occasionally during the day, and the pulse was natural. 30th, at 8^ A. M. Going on well; thought the distention as much as he could bear. At 1 p. M. Slight sympathetic tenderness over the Avhole of the abdomen ; pulse 104, irritable; uneasy from the distention ; pain of perineum on coughing ; tongue clean and moist. Gave him an opiate, and sent word to my medical friends, who met me at 3 p. M. I then, in their presence, emptied the dilator, and with- drew it, at the same time passing my left forefinger along it into the bladder. I immediately felt the stone, which was of small size, and in shape resembled a coffee bean, being about four times its size. It was removed with the scoop and finger. The pros- tate was well dilated, and would have allowed the removal of a calculus of more than an inch in its shorter diameter. The un- easiness of the abdomen and perineum disappeared on the with- drawal of the dilator. A lithotomy tube was then left in the wound. At 12, med. node. Urine had passed freely ; pulse 96 ; tongue moist; no pain ; had slept well. Ordered a dose of castor oil. 31st. Bowels not moved ; had an enema ; appetite good ; says he never felt better. August 1. A M. Complained of slight uneasiness, Avhich dis- appeared on the removal of the lithotomy tube ; going on well. At 10 p. M. was able to retain his urine, and could expel it by the wound. At midnight passed about half-a-cupful by the natural passage. He was directed to lie on his right side, to favour its passage along the urethra as much as possible.