On the comparative advantages of lithotomy and lithotrity : and on the circumstances under which one method should be preferred to the other : being the dissertation for which the Jacksonian Prize for 1838 was awarded / to Edwin Lee.

  • Lee, Edwin, -1870.
Date:
[1842]
Catalogue details

Licence: Public Domain Mark

Credit: On the comparative advantages of lithotomy and lithotrity : and on the circumstances under which one method should be preferred to the other : being the dissertation for which the Jacksonian Prize for 1838 was awarded / to Edwin Lee. 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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    gans, when the operator is careful to sus])end tlie operation should any unpleasant symptoms arise, till they have subsided. The same remark may ajiply to those persons in whom, though there be no evident disease of any important organ, the general health is materially impaired, either by a residence in tropical cli- mates, or other causes, and in whom there consequently exists a great predisposition to disease, which would very likely be called into activity by the performance of a capital operation. In the majority of such cases lithotomy, though not so strongly counter- indicated ns when there is actual disease, would yet be attended with great risk, and would be less advisable than lithotrity ; par- ticularly if other circumstances be in favour of this operation. In some persons, however, even when the symptoms of stone are not severe, a deranged state of the general health, and digestion, with feverishness and restlessness, depends upon the presence of tlie fo- rei^ body, and would be rectified on its removal; while the irri- tation from lithotrity, especially if many sittings were required, would be likely to be prejudicial. In such a case, therefore, litho* toiny would be the preferable method if other circumstances did not preclude its adoption. I have already adverted to the prejudicial effects which may en- sue from the undue degree of apprehension entertained by some patients of lithotomy, which most persons are aware, if it do not succeed, will probably cause their death. So great is the dread of some patients of lithotomy, that they are induced to bear their sufferings, and tamper with the disease for a long period, till the stone has attained a large size, or till morbid alterations super- vene, which either preclude an operation for their relief, or render its performance much more hazardous. To such persons the less formidable operation of lithotrity might often be proposed, with- out exciting their fears in the same degree, and at an early stage of the disease, when its removal would be comparatively safe and easy. In some instances, where the patients were particularly ap- prehensive of lithotrity, but found after two or three sittings that it was not so formidable as they supposed ; and after seeing some fragments pass away with but little inconvenience, their minds be- came much more easy as to the result, which had the happiest ef- fect in improving their general condition, and raising their spirits. In order, however, to prevent the despondeney that might arise, in the event of any unfavourable circumstances supervening, it w'ould be advisable on the part of the surgeon, not to lead the pa- tient to think too lightly of the operation, but to intimate that it is sometimes necessary to suspend the sittings for a time, without any harm necessarily resulting from the delay. When treating of the nature of calculi, as regards the operation best adapted for their removal, I alluded to the calculous deposi-