Recent advances in the methods of extracting stone from the bladder / by Sir Henry Thompson.

  • Thompson, Henry, Sir, bart., 1820-1904.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Recent advances in the methods of extracting stone from the bladder / by Sir Henry Thompson. 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.

    2/24 (page 2)
    ally proposed are often due rather to the idiosyncrasies of different operators, than to the discovery of any new or important fact. For the most part, the plan of incision known as the lateral method (‘ la taille laterale ’) is adopted throughout Europe, America, and the East, with slight variations in different localities; an important exception being Paris, where median operations, in the form of medio-bilateral or prerectal, are mostly preferred. There is one modification, however, which requires to he noticed, relating rather to the mode of dealing with the stone itself, than to the method of making the incisions. Doubtless the success which lithotrity achieved has led to the proposal, which in varied forms and in several quarters has been made, viz. to combine a limited degree of incision with the crushing operation; a plan which was more systematically pursued by the late Dr. Dolbeau of Paris than by any other surgeon. Dolbeau’s method, which he termed ‘ perineal lithotrity,’ consisted in making a median incision in front of the anus, limited to the urethra; in forcibly dilating the neck of the bladder by special instru- ments ; then crushing the stone by forceps introduced through the wound, and abstracting the debris by that route. It is worthy of note that Dolbeau recom- mended this procedure because ‘he knew by experience how great is the relief which follows extraction of all the calculus at a single sitting.’' And his method is one which, somewhat modified perhaps, and in exceptional cii’cumstances, as when the urethra is unduly narrow, may offer some advantages. But serious risk may be incurred by much manipulation for the purpose of remov- ing debris in an empty bladder, as most lithotomists have ' Be la Lithotntie perineale, p. 42. Paris: 1872. ‘ Pour ma part, je recommanderais oette pratique si je ne savais par experience combien est grand le soulagement qui succfede a I’extraction d'une pierre faite seance tenante.’