The modern treatment of stone in the bladder by litholapaxy : a description of the operation and instruments with cases illustrative of the difficulties and complications met with / by P.J. Freyer.

Freyer, P. J. (Peter Johnston), Sir, 1851-1921.

Date:: 1886

Credit: The modern treatment of stone in the bladder by litholapaxy : a description of the operation and instruments with cases illustrative of the difficulties and complications met with / by P.J. Freyer. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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$not justly attributable to the operation, the pati< having died from bronchitis, cold and neglect. Accept- ing the 5 deaths in connection with the operation, however, we find that, excluding the 3 operations on female children, there were 125 operations on adults with 5 deaths, or a mortality of 4 per cent. Compare these results with the recognized mortality of 1 in 4, or 25 per cent., from lithotomy in the adult! An impression seems to prevail, both in this country and in England, to the effect that lithotomy amongst the natives of India is a much more successful operation than amongst Europeans. Let us examine the facts of the case. In the end of 1884, when preparing an article on litholapaxy for publication, Surgeon-General A\ . Walker was good enough to lend me the latest pub- lished Medical Administration Reports of the various Presidencies and Provinces in India, and from these I compile the following Table Showing the Remits of Lithotomy Operations performed in Indian Hospitals in 1882. 3 SO a Result. s - O r-l CL 00 £ fc _= poo Presidency or Province. a th •-co o Total. 5 o o 3 o O -3 2 to ~ '5 '3 S - Pi 3 a 0 — - - z 1 — c Ph 0 181 187 148 5 5 19 10 10-5 1 in 9-5 N.-W. Provinces 49 933 982 824 11 11 85 51 91 I in 11 50 949 999 768 25 28 127 51 i::-i 1 in . 4 Central Provinces 5 IO 78 68 1 9 12-3 1 in 8 Bombay and Sindh 27 450 477 377 6 6 45 43 10-0 1 in 10 Madras 1 6 7 0 1 1 14 4 1 in 9 Total 138 2,592 2,730 2.190 48 51 286 155 110 I in 9$