Stone in the bladder : lithotomy in the infant and the child ; crushing the stone in the adult and old, with the application of lithotomy to each, in certain cases, practically considered / by Richard G. Butcher.

  • Butcher, Richard G. H., 1819-1891.
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Stone in the bladder : lithotomy in the infant and the child ; crushing the stone in the adult and old, with the application of lithotomy to each, in certain cases, practically considered / by Richard G. Butcher. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    the knife laid aside. I next introduced the gorget, its concave surface resting partly on the side and back of my finger nearly to the ti[), then Avith luilf a turn it glided into the bladder, when my finger was withdrawn, and the ibrceps, with its closed blades, and in Its narrowed axis, passed along it, the hand of the operator being in the prone position; the gorget was then laid aside, and 1 raised myself from the kneeling position; the instrument was rotated by half a turn, the hand being made supine. The stone, though felt, could not be readily seized, owing to the size of the instrument; a smaller one was passed in after a similar manner to the first, and on opening its blades and striking it gently the stone fell into the chops of the forceps, and was readily extracted by an up and down movement of the instrument as it rested upon the index finger of my left hand acting as a fulcrum beneath. By these combined and gentle movements the stone was extracted with the least possible force, and with comparatively little violence to the Avounded parts. The stone Avas composed of lithic acid, and about the size of a small walnut. Finally, the finger Avas passed into the bladder and swept all round it, to make certain that no second stone Avas there. The patient was next unbound, and the canule a chemise^ Avell oiled, introduced into the bladder, and retained by suitable tapes. He was then laid on his back in bed, a folded blanket under him, his knees tied together, with a small soft pad between, and the thighs slightly flexed, by a pilloAV placed beneath the hams; thus the Avound was protected from pressure, and a ready escape afforded for the water from the bladder. Quickly the child aAvakened from the chloroform, and was quite unconscious of Avhat had been done. 3 p.m.—No pain; urine passing freely through the canule. 21st.—The child slept the entire night free from pain, Avater passing abundantly through the canule. 3 p.m.—Urine floAving freely by the instrument—cut the retaining tapes, so as to leave it at liberty. 22nd, 9 a.m.—Urine flowing copiously through the wound, the canule having slipped out of its own accord. 29th.—Not an unpleasant symptom since the operation, and now for the first time some urine by the penis (ninth day after the opera- tion). Wound rapidly healing. Nov. 5th.—Nearly the entire of the urine passing by the penis, only a few drops by the Avound.