On litholapaxy / by Robert F. Weir.

  • Weir, Robert F. (Robert Fulton), 1838-1927.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: On litholapaxy / by Robert F. Weir. 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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    8, 1879 ; Bigelow’s lithotrite, size 33 Fr., used ; straight evacuating tube 30 Fr. ; greatest seizure ^ inch. Time occupied 40 minutes, most of which was taken up with the aspiration, not only to get rid of the last fragment, but also to determine by the absence of any clicking noise that nothing was left in the bladder. Detritus weighed 5lss, and was composed of the fusible phosphates. Very slight reaction. Recovery ensued, though obstinate cystitis remained, which resulted in Case III.^—In the same patient; operation repeated June*-;31, 1879, with Bigelow’s lithotrite; time occupied 35 minutes. As before, much time was spent in using the aspirator as a means of assuring one’s self that nothing remained behind. Reaction was sharp, and the patient showed unpleasant symptoms of threatened kidney complication, such as heaviness, copious turbid urine, and fever. These subsided at end of fourth day, and the case then progressed favorably. Case IV.—Dr. George A. Peters; operation. May 25, 1878. J. P., aged 64 ; Keyes’s lithotrite used : greatest seizure | inch ; lithotrite in bladder 50 minutes first time, introduced in all 3 times, occupying 76 minutes. Aspir- ator tube in bladder 19 minutes. Total time of operation 1 hour 45 minutes. Weight of stone 253 grs. Composition uric acid. Sharp vessical irritation followed for three days with but slight constitutional disturbance. Complete recovery. Case V.—Dr. C. M. Allen; operation, Nov. 7, 1878. Jno. P., aged 51; Keyes’s lithotrite used ; time of operation 66 minutes. Lithotrite introduced 4 times, and remained in bladder 39 minutes. Straight evacuating tube, size 30 Fr., employed for 22 minutes. The stone weighed 398 grs., and its composition was of the mixed phosphates. The nucleus, which was a small piece of wax, was withdrawn imbedded in the eye of the evacuating tube. The patient made a rapid recovery, and was out of the house in seven days. Case VI.—Dr. H. B. Sands; operation, Oct. 28, 1878 ; male, aged 69. A fenestrated lithotrite was used. The operation lasted seventy minutes. The aspirator was used twice; a curved evacuating tube, No. 28, was employed, a straight one having failed to enter. The greatest grasp was ll- inches. The weight of thei collected fragments, some of which were lost, was 90 grains. The stone consisted of uric acid. No reaction from the operation occurred, and the patient made a speedy recovery. Case VII.—Dr. H. B. Sands reports one case of rapid reformation of stone in an elderly gentleman, who had some time previously been lithotomized, and on May 20th, July 31st, Oct. 10th, and Nov. 1st, 1878, was relieved of calculi of phosphatic formation, by litholapaxy, the sittings being about half an hour each in duration, except the first, which lasted an hour. The quantity of stone removed was 360 grains in all. Collin’s lithotrite was used. Since the last operation, the patient has acquired the use of the catheter, which had previously failed to be borne, and the reformation of calculus has thereby been prevented. Case VIII.—Dr. McBurney; operation, Aug. 15j, 1878. Alfred P., aged 32. Keyes’s lithotrite. Duration of operation, two hours and twenty-three minutes, in which time the lithotrite was employed six times, and the aspirator six times, with curved evacuating tube. No. 26 Fr. in size. The largest seizure was seven-eighths of an inch. The stone was phosphatic, and weighed 5iij- Temperature next day was 101.6°, which declined to normal in four days. Patient had a very satisfactory recovery. Case IX.—Dr. J. C. Hutchison; operation. May 22, 1879; patient aged 76. Bigelow’s and Keyes’s lithotrites used. The latter worked badly, pinching off pieces of mucous membrane three times. Bigelow’s aspirating tubes. The operation lasted two hours. The stone was phosphatic, and the largest grasp was 1§^ inches. No reaction followed, and the result was satisfactory. Case X.—Dr. G. H. Fox; operation, Nov. 9, 1878. On a consumptive man, by means of Keyes’s lithotrite and Bigelow’s aspirator. Stone was 1^ inches in diameter. The oj)eration, after continuing seventy-five minutes, and 154