Observations based on the probable mode of formation of urinary stone relative to its recurrence and prevention / by Reginald Harrison.

  • Harrison, Reginald, 1837-1908.
Date:
1901
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Licence: In copyright

Credit: Observations based on the probable mode of formation of urinary stone relative to its recurrence and prevention / by Reginald Harrison. 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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    operations rarely detained the patient to the house for more than a few days. In this case the urine was so continually alkaline and ammoniacal that I finally tried the artificial induction of the lactic fermentation, apparently, as in other instances, with success in preventing the precipitation of the mixed phosphates. This was first suggested by the late Sir William Eoberts,'® the object being to bring about and maintain an acid reaction of the urine by overpowering the ammoniacal tendency until the bladder, so to speak, bad time to return to a more normal condition. Case 2.—In this case a man, aged 60 years, was seen by me in 1890 with Mr. F. Grant. A phosphatic calculus weighing two drachms was removed by litholapaxy in March of that year. During that year and the subsequent year he suffered from several recurrences which required removal by the lithotrite and washbottle. This entailed his giving up an active professional life. In 1891 he commenced the systematic method of washing out described and has had no further return since. Writing to me in 1899 be says: “ I still, however, go on with the washing out, as I should not feel safe without it, and it is no trouble.” He has resumed his work as usual. As in the previous case, the patient told me that he had been frequently advised to submit to a lithotomy and bladder drainage. He remains quite well. Case 3.—In the following case, though no recurrence of the stone took place, it will be seen how this was pro- bably averted. It was that of a man, aged 67 years, whom I saw in 1893 and from whom I removed a stone by litholapaxy weighing one drachm. There was some prostatic enlargement. By regularly washing out the bladder in the way described from time to time with a solution of boric acid, masses of shreddy mucus containing triple phosphate crystals were frequently removed. Under the use of silver nitrate solution these eventually disappeared. In 1898, in spite of attention of this kind, considerable difficulty was experienced by him in using his catheter by reason of further enlargement of the prostate, cystitis, and repeated attacks of epididymitis. Again his urine became largely charged 13 A Case of Lactic Fermentation in the Bladder, with Suggestions for the Use of the Lactic Fermentation as a Counter-septic Agent in Cases of Ammoniacal Decomposition of the Urine, Thk Laxcet, Feb. 25th, 1893, p. 405.