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.

    52/66 (page 18)
    Wthj, The degree of pain from the performance of lithotrity is not great in many cases, and is mostly diminished after the first sittings; but, on the other hand, in some instances, the operation is very painful, and the pain becomes increased in subsequent sit- tings, though, perhaps, never so acute in lithotrity asm lithotomy, yet, as the pain in the latter operation lasts only for a few minutes, ■whereas in the former it recurs, though less in degree, on each sitting, the patient frequently sutFers by lithotrity a greater amount of pain. 10^///^, The duration of the treatment is generally longer by lithotrity than by lithotomy, though sometimes it is shorter; and after the stone has been removed by the latter operation, the pa- tient, though confined to his bed, may, during the greatest part of the period, be considered as convalescent; whereas, when li* thotrity is performed, there is always a risk, so long as any frag- ments remain in the bladder, of circumstances arising to prevent the completion of the operation, and the patient cannot be regarded as out of danger. Wthhj, When lithotrity is applicable, the method by pressure is, in the great majority of cases, infinitely superior to that by per- cussion. 12M/y, Lithotrity exposes more to the risk of a relapse than lithotomy, on account of the greater probability of a portion of stone having eseaped detection, and remaining in the bladder af- ter the operation. Lastly^ Sufficient data do not as yet exist whereon to form any accurate estimate of the average amount of failure, and mor- tality after lithotrity; the accounts hitherto furnished being of a very contradictory nature ; some representing lithotrity as more successful in its results than many slight operations; others stat- ing the number of failures to be very great. The circumstance of several unsuccessful cases, which were not adverted to by the operators, having been subsequently brought to light, both in England and on the continent, tends very much to discredit some of Uie statements of success which have been made ; though, as far as the results are concerned, much must depend upon the opera- tors being accustomed to the use of the instruments, and knowing when to desist from persevering in the attempts; as also upon the selection of proper cases. It is, however, satisfactory to know, that, since the instruments have become more simple and perfect in their construction, and the operation better understood by the generality of practitioners, the proportion of failures is much less than at an earlier period. Appendix.—The following few cases are selected, in order to illustrate some points connected with lithotrity; the difficulties