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
Catalogue details

Licence: Public Domain Mark

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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    On December G I performed litholapaxy, the urethral calculus having first been removed after slitting the floor of the urethra slightly. The operation lasted sixty-six minutes, and the debris weighed 8J ounces, the calculus being a hard uric- acid one. Considerable trouble was at first experienced in grasping the stone owing to the contraction of the walls of the bladder on it. This was obviated by injecting water into the bladder. The lithotrite was introduced at, least a dozen times, and after each crushing a large quantity of debris was washed out through a No. 18 canula. With the exception of slight pain in micturition during the first day or two, the patient had no after-trouble. He made a rapid recovery, and on December 15, when discharged from the hospital, the following entry in my note-book describes his condition :— Patient now rid of all bladder symptoms. Urine quite clear ; bladder retains a large quantity at a time. Has grown fat and strong. Says he has not been so well for several years. This man was a miserable creature on admission to hospital ten days ago, and now leaves it in excellent health. ' Case CXXIII.—A Mahoruedan male, aged 60, admitted into the Mussoorie Hospital, August 29, 1885, with symptoms of stone. On passing a sound, the presence of a large calculus was confirmed. The patient stated that the symptoms had existed thirty years, but that they were extremely aggravated during the last three years. He was very weak and emaciated, and scarcely able to stand up. He agreed to an operation, provided that it should not be a cutting one. On the 30th of August I performed litholapaxy, Surgeon- Major W. Murphy, I.M.S., and Surgeons A. Kavenagh and C. R. Tyrrell, Medical Staff, being present. Chloroform was given by Dr. Tyrrell. A large sound, No. 11, was first passed with ease, after slitting the floor of the meatus slightly. I then attempted to pass the largest lithotrite. but its beak was arrested by a pouched condition of the urethra near the