Proceedings of Societies

Abstract

bistoury. In a second cas, that of Hisgate, a fusible calculus crumbled to atoms within the grasp of the forceps, and was partially removed with the scoop and warm water injections. In the third case, that of Leonard Garner, a brittle oxalate calculus, weighing one ounce and a half, broke up into thirteen fragments, one of which was only detected and removed with the forceps from the bladder after placing the patient in bed. Result.-The ten first operated upon recovered, the remaining three died. First, Jary,. aged 35, on the fourth day, from secondary hnemorrhage; second, Kemp, aged 67, a very unfavourable subject, case of triple calculus, on the twenty-ninth day, from exhaustion; and the third, Gosling, aged six years and a half, in thirtysix hours, diarrhoea and stupor supervening. The instruction derived irom witnessing and assisting at numerous lithotomy operations, including two in which no stone was found, conducted with the gorget, beaked knife, or common scalpel, led in each case to the employment of the cutting gorget, as the safest and best instrument in not over experienced or dextrous hands, to insure limited incision of the prostate and neck of the bladder, a point of the first and very highest importance. The blunt gorget or finger served as a dilator of the wound, and in each instance, where an elastic tube was not left in the bladder, the finger was gently passed a few hours after the operation to lessen the danger of urine becoming effused into the pelvic cellular tissue. Since the practice of lithotrity and the more frequent use of the catheter-forceps,* operations for lithotomy appear to have become comparatively more rare in this district. The five cases just reported, commencing with that of Stanfield, include the whole number lately performed at the Lynn Hospital.