A case of vaginal lithotomy : with remarks on stone in the female as it occurs at the Norfolk and Norwich Hospital ... [and 3 other papers] / by Charles Williams.

  • Williams, Charles, 1827-1907.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A case of vaginal lithotomy : with remarks on stone in the female as it occurs at the Norfolk and Norwich Hospital ... [and 3 other papers] / by Charles Williams. 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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    one stone was found in every bladder, in 2 females, two stones were found in each bladder. In 21 cases the calculi consisted of uric acid and urates; in 21, of mixed phos- phates ; in 7, phosphates and urates; the rest, mixed. So far as I can ascertain, this is the first time that a case of stone in the female bladder has been operated on by vaginal lithotomy at the Norwich Hospital. The speci- mens of calculi removed from the fifty-two females arc preserved in the museum attached to the institution, and to the greater number is appended the word “extracted.” I presume that this word signifies removed by means of dila- tation, with probably division of the urethra, or else division of the urethra without dilatation. Unfortunately there are no records at the hospital to indicate what has been the precise nature of the operation performed on females. The only allusion to the subject in Mr. J. G. Crosse’s work on Calculus is contained in the following passage: “ Female patients were at an early date operated on by cystotomy, but of late years all calculi from the bladders of females have been removed by dilatation.” What the operation “ cystotomy ” was there is no evidence to show. Mr. Crosse does not describe what he means by that term—a term which simply signifies the operation of opening the bladder, be it male or female, for the extraction of the stone. The word itself does not indicate any exact kind of operation, so we are left in the dark as to what was done by our fore- fathers at this hospital. It is supposed that vaginal lithotomy is an operation of modern date; it certainly is one rarely performed, inas- much as Dr. Avcling, in an excellent paper on the subject, printed in the Obstetrical Transactions for 1863, could not find more than thirteen cases published in British surgery, and twenty-two in foreign. Curiously enough three of the thirteen cases are recorded by a Norfolk sur- geon, Benjamin Gooch, with whom the operation seems to have originated. In his work on Surgery, dated 1767, he states as follows:— “Mrs. T , aged between forty and fifty, after having