Litholapaxy / by Edward L. Keyes.

  • Keyes, E. L. (Edward Lawrence), 1843-1924.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Litholapaxy / by Edward L. Keyes. 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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    for two or three consecutive hours in the bladder without harming the patient. In a conversation recently, Professor Bigelow remarked to me that it made no difference if the operation lasted a week, indicating his entire disregard of time as an element to be considered in the operation. Bige- low, from the first, has maintained that rapid lithotrity should be done slowly. In this statement he is certainly correct, for by slowly he means deliberately, carefully, disregarding time as an element of the operation. By such a method of operation alone can that gentleness of manipulation be assured which shall spare the bladder and urethra as much violence as pos- sible. But when this gentleness of manipulation has been attained nothing more can be expected from slowness and deliberation in operating. Other things being equal the more expert the operator, the more rapidly will he finish his work, using the same or greater gentleness than another whose touch is less familiar with the business in hand. Prolonged etherization alone is harmful to some patients, and if only on this account brevity in the operation is desirable. That Bigelow believes this is shown by the large size of the tubes he advocates and habitually employs. Thompson, who has performed rapid lithotrity more often than any one else, has gradually extended the limit of time, he is will- ing to allow for an operation. His last utterance places it at about half an hour, but the wonderful dexterity of this veteran operator would ensure him a yield in a half hour possibly twice or three times as large as the general surgeon could aspire to in the same time, and for the general surgeon the caution is a wise one that no sacrifice of patient gen- tleness is allowable in this operation in order that few or many minutes may be saved. My experience has taught me that an operator reasonably well versed in the old method may find great variations in regard to time with