A treatise on the formation, constituents and extraction of the urinary calculus; being the essay for which the Jacksonian Prize for ... 1833 was awarded / by John Green Crosse.

  • Cross, John, 1790-1850.
Date:
1835
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the formation, constituents and extraction of the urinary calculus; being the essay for which the Jacksonian Prize for ... 1833 was awarded / by John Green Crosse. Source: Wellcome Collection.

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    had fever with flashed cheeks; no other unfavourable sign occurred, however, until the fifth day after the operation, when a cold chill arose, continuing for a quarter of an hour and giving place to a regu¬ lar fever-fit. A restless night was passed, and on the sixth day the penis was swollen from serum in the cellular texture. In spite of cold evaporating lotions, the scrotum, by next day, was as large as an egg; I relieved it by scarifying, but soon it became evident that there was erysipelas spreading, a blush being present on each groin, attended by tumefaction; there was also a daily febrile attack, and the perinseal wound became pale, yellow at the edges and patulous, furnishing no healthy discharge. The tumefaction and redness gradually subsided in the parts first affected; an erysipelatous blush spread from the buttocks, over the loins, as high as the shoulders, occupying the whole of the back, and like¬ wise proceeding, more slowly, downwards nearly to the knees; upon the buttocks and loins, there were considerable tumefaction and a few vesications, but, on the more distant parts, the disease was marked by a pink hue only, without vesication and with very little swelling. After lasting two or three days, the redness went off, and the cuticle desquamated, so that on the fourteenth day from the operation, all erysipelatous affection had disappeared, save that the scrotum, prepuce, and left buttock were swollen from remaining serum; still the child did not regain appetite, the system was emaciated, countenance and lips pale, with restlessness and a fretful state of mind. Sulphate of quinine and dilute wine failed to rouse the exhausted energies of the system, and death ensued at the end of three weeks. The viscera of the abdomen, when inspected, exhibited no marks of disease; neither did the bladder nor the other contents of the pelvis; the only visible effects of the erysipelatous disease were the presence of a quantity of yellowish serum in the cellular tissue of the prepuce, scrotum, groins, upper part of the thighs, buttocks, loins, and anterior part of the abdominal parietes, from the pubes as high nearly as to the umbilicus. The parts concerned in the operation are represented in plate xxi, fig. 2; the urine took a direct course from the bladder to the wound in the perineeum, without any lodgment or infiltra¬ tion ; the fatal issue was from erratic erysipelas and the attendant fever, destroying the remaining powers of a very feeble system. For sometime after this date, erysipelas continued so rife in Norwich, that fatal attacks occurred after bleeding, cupping, leech-bites, and the simplest incised wounds, making it unsatisfactory to the surgeon to undertake any operation, whether in or out of the hospital; in this institution lithotomized patients were not spared; the particular tendency to this disease continued for above two years, and owing to this danger, in the year 1829, only three patients underwent the operation of litho-cystotomy within its walls. Case X. On the 8th of January, 1818, Mr. Bond, formerly one of the surgeons to the Norfolk and Norwich Hospital, operated upon a man sixty-nine years of age. The symptoms were stated to have existed only two years ; but the staff seemed to pass over so large a calculous surface when moved about in the bladder, that the stone was pronounced to be very large, and an ample external incision was made accordingly. It seemed to me that the staff was bared at the bulb of the urethra, and a copious flow of venous blood took place. The bladder being reached by the scalpel, a blunt gorget was used to conduct the forceps into the bladder. The stone was soon grasped by the forceps, but not soon ex¬ tracted, the wound requiring to be enlarged repeatedly, in a direction downwards and outwards, with the scalpel; Mr. Martineau, who was present, feeling resistance from the soft parts, on the opposite side, towards the symphysis pubis, cut a little in that direction; and at length a stone weighing five ounces was extracted. In forty-eight hours, the abdomen was painful and very tender to the touch, pulse one hundred and twenty; two copious bleedings from the arm relieved the symptoms; the blood /