Report of twenty-five cases of urinary calculus, in twenty-three of which the bi-lateral operation was performed / by Paul F. Eve.

  • Eve, Paul F.
Date:
[1852]
Catalogue details

Licence: Public Domain Mark

Credit: Report of twenty-five cases of urinary calculus, in twenty-three of which the bi-lateral operation was performed / by Paul F. Eve. Source: Wellcome Collection.

    9/18 (page 49)
    * Case XIX.—The son of a professional brother, Dr. S., in Coweta County, Georgia, was cut in June, 1851. He was seven years old, had two friable calculi, one’ of which was removed nearly whole, the other after it was broken up. They would weigh about three drachms, and are composed of oxalate of lime nuclei covered with about one-eighth of an inch of phosphate of lime. I have just received a letter in which occurs the sentence: “ The condition of Dr. S.'s son is such as you would desire it to be, a perfect cure. Case XX.—Up to this number, but one of my patieuts had died after being operated upon; all had fully recovered with a single exception, and death in that instance was not attributed to lithotomy. But of my remaining cases, that is, of the last six operations, no less than three had a fatal termi¬ nation. The first of these was in the person of Mr. T., of De Kalb County, Georgia, aged seventy-seven. He had been afflicted for years with calculous symptoms; for the last ten had daily used a catheter; knew he had a stone in the blad¬ der, for, besides feeling it with his silver catheter, its eyes or openings near the beak would occasionally be plugged with fragments of an urinary concre¬ tion, and having; endured the extreme of human suffering; now demanded, at all hazard, an operation. The usual bi-lateral section was made, but owing to the size of the prostate gland, the bladder could not be explored with the finger. Like, in Case XV., a foreign body could only be felt, but not seized with instruments. After repeated efforts, the fragment of a calculus, size of a rifle-ball, was detached by the scoop; the operation was now discontinued, and the old gentleman died at the end of sixty hours, of course from the direct effects of it. His family physician, Dr. E. N. Calhoun, fortunately made a post-mortem examination, and thus describes the condition of the organ opened in the ope¬ ration: “After cutting into it (as in the high method for stone), I found the walls of the bladder thickened to the extent of from one-fourth to three- eighths of an inch, and perfectly infiltrated with blood. It contained a large quantity of bloody water, of course very offensive, and there were three dis¬ tinct cysts, each containing quite a number of small calculi. The one sent (about the size of a partridge egg) “1 took from the sac nearest the fundus. Case XXI—This was my first in Tennessee, and was operated upon in November, 1851. Mr. T., aged twenty-four, had suffered calculous symp¬ toms for years, and had recently returned from a visit to California by the Isthmus. He was cut in the presence of several members of the medical class of the Nashville University, and a very, rough mulberry calculus, weigh¬ ing about half an ounce, removed. In physical appearance it resembles very much the one removed thirteen months before, near Milledgeville in this State, but differing widely from it in composition. The bleeding was rather free after the operation, but a careful examination did not expose any particular vessel from which it proceeded; the blood seemed to be derived from the plexus about the neck of the bladder. It soon ceased to return during the night after the expulsion of a coagulum, when it was permanently arrested, as in Case XYI1I., by a female catheter, armed with a linen pocket and stuffed with lint. This patient was ready for home in less than two weeks. Case XXII.—On the 10th of December, 1851, I removed, in Nashville, a calculus from the daughter of Dr. I)., of Tennessee, on her fifth birth day. The double lithotome introduced into the bladder touched the foreign body,