- Email: [email protected]
STONE IN THE BLADDER SUCCESSFULLY TREATED BY LITHOTRITY.
806 of support; since which, in forty years’ extensive practice, he had the good fortune to meet with no more such distressing cir-
FOREIGN DEPARTMENT.
cumstances.
Case 2. A lady in this parish was delivered by a female midwife. The labour was fair and easy, and every thing went on STONE BLADDER SUCCESSFULLY IN THE to her wishes; the midwife left her withTREATED BY LITHOTRITY. out pressing the abdomen, or applying a bandage, while she dedicated her time to THE extraordinary success which M. Civiale the child. A few minutes after this, her has experienced by his method of treating patient grew faint, turned pale, and quickly stone in the bladder, entitles it to more atexpired. There was no external hemorrhage. tention than has hitherto been bestowed on On the post-mortem examination, the it by the practitioner of this country. We uterus was found filled with fluid and coa- presume that our readers are acquainted gulated blood, and extended to the scrobi- with this method, and have no doubt that culus cordis. following case will contribute to excite " The remarks I have to offer on these their interest in its favour. cases are-the necessity of compression of Moiin, 68 years of age, of a very the abdomen immediately after the expul- irritable temperament, began, in 1825, to sion of the placenta; the examination of be affected with considerable strangury and the pulse and countenance, and not too dysuria. The application of leeches and a departure of the practitioner, as in poultices to the perineum, warm baths, and all those who have been rescued, it has a spare diet, relieved these symptoms, but been accomplished by the prompt introduc- did not prevent their frequent recnrrence tion of the hand into the cavity of the ute- during IBi6. At this time hectic fever rus for the discharge of its contents, aided began to appear, and the urine deposited by external compression, and the mechani- purulent matter, the quantity of which gracal stimulus of the hand bringing on its dually increased. As the patient obstiproper contraction. Should these fail, there nately refused to be sounded, it is uncer. is only one. more resource-the transfusion tain whether, at this period, a stone had of human blood, recommended by my friend been formed. The symptoms becoming, Dr. Blundell." however, more urgent, the patient was at ’’ We are informed by Mr. Gaitskell,whose last sounded, and a stone was found in the experience has been almost unlimited, that, bladder, which was so irritable that the out of 7,000 cases of midwifery, occurring introduction of the sound was followed in his practice duringthe last forty-five by acute cystitis, which could only be years, he cannot recollect a single instance reduced to a sub-inflammatory state by a of fatal uterine haemorrhage. Before he very active antiphlogistic treatment. Under constructed this bandage, he was in the these circumstances, M. Civiale’s method was constant habit of employing a small table proposed, and although the hectic state of napkin. But the bandage in question is the patient, colliquative sweats, the greatest more extensive in its application, while it debility, with nausea, &c., gave a very is extremely simple ; as it is applied at the unfavourable prognosis, this gentleman very commencement of labour, and follows readily consented to perform the operation it through all its different stages." (This is of lithotrity. a.reviewer’s remark.) The patient was prepared for it by light N. B. The bandage is made by a poor tonics, with small doses of opium and emoldeformed young woman (Miss Grierson, lient clysters ; at the same time a nourishNo. 6, Bedford Place, Deptford Lower ing diet, semicupia, and poultices on the Road), and costs but four shillings. It abdomen, were employed. The strength of will last a female for life. the patient was by these means somewhat P..S. Mr. Gaitskell forgot to mention, improved, and the fever, in some degree, that, before the bandage is put an,, its uti- subsided ; the urine continued, however, lity would be increased, if a small pillow to be purulent. The irritability of the bladwere placed on the abdomen, previously to der had so far diminished, as to admit of the daily introduction of an elastic bougie, drawing the tapes. and of its remaining for some time in thee [The passages in inverted commas, have bladder. At the beginning of April, 1S:’!’, been taken from a small tract published by the health of the patient appeared to be so Mr. Gaitskell.] much improved, that it was thought advisable not to delay the operation any longer. The learned Lecturer quitted the theatre An injection of tepid water was made, amidst the enthusiastic applauses of a highly. and although performed with the greatest caution, this part of the operation, as ivell respectable numerous class.
the
·----
hasty
807 the introduction of the small forceps,!tiered, but rather of medical policy ; it conin salting the bodips with appeared to cause excessive pain, and made sisted, originally, natron, with which the country abound!:, the patient almost intractabie : at last Civiale succeeded in taking hold of f and in afterwards drying them ; when thus The forceps being of smaller di-, prepared, the bodies were -deposited in. stone. mensior.s than usual, and the stone, on places inaccessible to the inundation, and which were the better suited to this purpose, account of the great sufferings of the not being well fixed, only a small part of it ’t as being, from the same reason, stenh’. 1’his Some slight! was the original mode of embalming; the could be reduced to additional processes, which were gradually irritation of the bladder followed this introduced, are to be regarded merely us attempt, and the quantity of purulent ter in the urine increased ; however, in a 1 the effect of luxury. According to M. 1’ashort time, this exacerbation was subdued, riset, it appears from the most accurate inand the patient appeared to experience quiries, that in the fourth century of our inuch more relief than was expected. era, the custom of embalming began to fall Oh the 31st of May the operation was into disuse in Egypt ; that the oriental plague did not show itself before the beginrepeated, but without much success. On the 9th of June, the patient seemed ning of the sixth, and that the diseases, less affected by the introduction of the for- which are described by Greek authors, and in the scriptures, evidently want the chaceps, and a considerable portion of stone was reduced to powder, and after- racteristic symptoms of the plague. Before wards voided with the urine. the sixth century, Egypt had, for nearly .On the 14th of June, the operator wasthree thousand 3ears, been one of the most able to introduce a larger pair of forceps, health’? countries in the world ; but the and a great quantity of powder and frag- Christian religion having been introduced ments of the stone was passed after the Egypt, the custom of embalming was
as
theM.B patient,
powder.
first mat-
I
the
I
into
’
operation.
At the fifth
successful, the
pain ; but,
on
looked
upon
as
a
profane ceremony, and
during the fifth and sixth centuries it was, patient according to Abbe Fleury’s statement, forthe following evening, in- mally prohibited, and the present mode of
operation,
which was very felt scarcely any
flammation of the left testicle and sperma- inhumation introduced. In the year 542, tic chord ensued : by the means of leeches, 98 years before the conquest of Egypt by poultices, and absolute quiet, these symp- the Arabians, the first and most terrible toms subsided within a fortnight. epidemy appeared. From the coincidence The sixth and seventh operations were of these historical facts, it seems very likely not followed by any bad symptom, and a that the interment of the dead), in a coungreat portion of the stone was removed in try which, after a yearly inundation of four months, is exposed to an intense heat,) and powder and small pieces. The eighth operation seemed to have the subsequent putrid fermentation of anicompteted the cure, and, on the 1st ofmal matter, were the original causes of the ’August, the health was almost perfectly plague. Humidity, a certain degree of atmorestored ; the urine was passed regularly spheric heat, aud animal matter, are, acwithout any pain, the patient had regained cording to M. Pariset, the conditions necesthe development of the plague. In his strength, the fever had entirely disapno country of the world do these ctrcumpeared, &c. On the 6th of August, on examination, stances concur in such an eminent degree, some fragments were discovered, which as in Egypt ; and thus it is very e!15i!y exwere easily reduced to powder, or extracted. why this formidable disease should On further repeated examinations, no have originated in it. From thence it was trace of any remaining fragments could be:’ carried into other countries ; but in the latfound, and the patient, at the time of draw- ter the disease is not so terrible, nor do ing up the report, (in the middle of 18!28,’ithe conditions exist there necessary for the spontaneous production of the plague. enjoyed excellent health. As a strong proof of the former, it may be mentioned, that at Smyrna, ships from ConON THE ORIGIN OF THE PLAGUE. stantinople are never put into quarantine, In the Revue Médicale, 1B1. Pariset brings while those from Egypt always are so. forward a new opinion on the object of em- M. Pariset maintains, that the best, if not in Egypt. He endeavours to show, the only, means of arresting the further proby statistical calculations, that the inhabi- gress of the plague, is the re-introduction of tants of this country possessed no other embalming in to the extent to which means of protecting themselves against the it was formerly We conclude this notice with stating, injurious effluvia of putrid animal substances, and that it was, consequently, not an that M. Pariset left Paris, at the end of last for Marseilles, in order to examine object of religion, as has hitherto been be-
or
sary for
,
plained,
balming
Egypt, adopted.
month,
FOREIGN DEPARTMENT.
cumstances.
Case 2. A lady in this parish was delivered by a female midwife. The labour was fair and easy, and every thing went on STONE BLADDER SUCCESSFULLY IN THE to her wishes; the midwife left her withTREATED BY LITHOTRITY. out pressing the abdomen, or applying a bandage, while she dedicated her time to THE extraordinary success which M. Civiale the child. A few minutes after this, her has experienced by his method of treating patient grew faint, turned pale, and quickly stone in the bladder, entitles it to more atexpired. There was no external hemorrhage. tention than has hitherto been bestowed on On the post-mortem examination, the it by the practitioner of this country. We uterus was found filled with fluid and coa- presume that our readers are acquainted gulated blood, and extended to the scrobi- with this method, and have no doubt that culus cordis. following case will contribute to excite " The remarks I have to offer on these their interest in its favour. cases are-the necessity of compression of Moiin, 68 years of age, of a very the abdomen immediately after the expul- irritable temperament, began, in 1825, to sion of the placenta; the examination of be affected with considerable strangury and the pulse and countenance, and not too dysuria. The application of leeches and a departure of the practitioner, as in poultices to the perineum, warm baths, and all those who have been rescued, it has a spare diet, relieved these symptoms, but been accomplished by the prompt introduc- did not prevent their frequent recnrrence tion of the hand into the cavity of the ute- during IBi6. At this time hectic fever rus for the discharge of its contents, aided began to appear, and the urine deposited by external compression, and the mechani- purulent matter, the quantity of which gracal stimulus of the hand bringing on its dually increased. As the patient obstiproper contraction. Should these fail, there nately refused to be sounded, it is uncer. is only one. more resource-the transfusion tain whether, at this period, a stone had of human blood, recommended by my friend been formed. The symptoms becoming, Dr. Blundell." however, more urgent, the patient was at ’’ We are informed by Mr. Gaitskell,whose last sounded, and a stone was found in the experience has been almost unlimited, that, bladder, which was so irritable that the out of 7,000 cases of midwifery, occurring introduction of the sound was followed in his practice duringthe last forty-five by acute cystitis, which could only be years, he cannot recollect a single instance reduced to a sub-inflammatory state by a of fatal uterine haemorrhage. Before he very active antiphlogistic treatment. Under constructed this bandage, he was in the these circumstances, M. Civiale’s method was constant habit of employing a small table proposed, and although the hectic state of napkin. But the bandage in question is the patient, colliquative sweats, the greatest more extensive in its application, while it debility, with nausea, &c., gave a very is extremely simple ; as it is applied at the unfavourable prognosis, this gentleman very commencement of labour, and follows readily consented to perform the operation it through all its different stages." (This is of lithotrity. a.reviewer’s remark.) The patient was prepared for it by light N. B. The bandage is made by a poor tonics, with small doses of opium and emoldeformed young woman (Miss Grierson, lient clysters ; at the same time a nourishNo. 6, Bedford Place, Deptford Lower ing diet, semicupia, and poultices on the Road), and costs but four shillings. It abdomen, were employed. The strength of will last a female for life. the patient was by these means somewhat P..S. Mr. Gaitskell forgot to mention, improved, and the fever, in some degree, that, before the bandage is put an,, its uti- subsided ; the urine continued, however, lity would be increased, if a small pillow to be purulent. The irritability of the bladwere placed on the abdomen, previously to der had so far diminished, as to admit of the daily introduction of an elastic bougie, drawing the tapes. and of its remaining for some time in thee [The passages in inverted commas, have bladder. At the beginning of April, 1S:’!’, been taken from a small tract published by the health of the patient appeared to be so Mr. Gaitskell.] much improved, that it was thought advisable not to delay the operation any longer. The learned Lecturer quitted the theatre An injection of tepid water was made, amidst the enthusiastic applauses of a highly. and although performed with the greatest caution, this part of the operation, as ivell respectable numerous class.
the
·----
hasty
807 the introduction of the small forceps,!tiered, but rather of medical policy ; it conin salting the bodips with appeared to cause excessive pain, and made sisted, originally, natron, with which the country abound!:, the patient almost intractabie : at last Civiale succeeded in taking hold of f and in afterwards drying them ; when thus The forceps being of smaller di-, prepared, the bodies were -deposited in. stone. mensior.s than usual, and the stone, on places inaccessible to the inundation, and which were the better suited to this purpose, account of the great sufferings of the not being well fixed, only a small part of it ’t as being, from the same reason, stenh’. 1’his Some slight! was the original mode of embalming; the could be reduced to additional processes, which were gradually irritation of the bladder followed this introduced, are to be regarded merely us attempt, and the quantity of purulent ter in the urine increased ; however, in a 1 the effect of luxury. According to M. 1’ashort time, this exacerbation was subdued, riset, it appears from the most accurate inand the patient appeared to experience quiries, that in the fourth century of our inuch more relief than was expected. era, the custom of embalming began to fall Oh the 31st of May the operation was into disuse in Egypt ; that the oriental plague did not show itself before the beginrepeated, but without much success. On the 9th of June, the patient seemed ning of the sixth, and that the diseases, less affected by the introduction of the for- which are described by Greek authors, and in the scriptures, evidently want the chaceps, and a considerable portion of stone was reduced to powder, and after- racteristic symptoms of the plague. Before wards voided with the urine. the sixth century, Egypt had, for nearly .On the 14th of June, the operator wasthree thousand 3ears, been one of the most able to introduce a larger pair of forceps, health’? countries in the world ; but the and a great quantity of powder and frag- Christian religion having been introduced ments of the stone was passed after the Egypt, the custom of embalming was
as
theM.B patient,
powder.
first mat-
I
the
I
into
’
operation.
At the fifth
successful, the
pain ; but,
on
looked
upon
as
a
profane ceremony, and
during the fifth and sixth centuries it was, patient according to Abbe Fleury’s statement, forthe following evening, in- mally prohibited, and the present mode of
operation,
which was very felt scarcely any
flammation of the left testicle and sperma- inhumation introduced. In the year 542, tic chord ensued : by the means of leeches, 98 years before the conquest of Egypt by poultices, and absolute quiet, these symp- the Arabians, the first and most terrible toms subsided within a fortnight. epidemy appeared. From the coincidence The sixth and seventh operations were of these historical facts, it seems very likely not followed by any bad symptom, and a that the interment of the dead), in a coungreat portion of the stone was removed in try which, after a yearly inundation of four months, is exposed to an intense heat,) and powder and small pieces. The eighth operation seemed to have the subsequent putrid fermentation of anicompteted the cure, and, on the 1st ofmal matter, were the original causes of the ’August, the health was almost perfectly plague. Humidity, a certain degree of atmorestored ; the urine was passed regularly spheric heat, aud animal matter, are, acwithout any pain, the patient had regained cording to M. Pariset, the conditions necesthe development of the plague. In his strength, the fever had entirely disapno country of the world do these ctrcumpeared, &c. On the 6th of August, on examination, stances concur in such an eminent degree, some fragments were discovered, which as in Egypt ; and thus it is very e!15i!y exwere easily reduced to powder, or extracted. why this formidable disease should On further repeated examinations, no have originated in it. From thence it was trace of any remaining fragments could be:’ carried into other countries ; but in the latfound, and the patient, at the time of draw- ter the disease is not so terrible, nor do ing up the report, (in the middle of 18!28,’ithe conditions exist there necessary for the spontaneous production of the plague. enjoyed excellent health. As a strong proof of the former, it may be mentioned, that at Smyrna, ships from ConON THE ORIGIN OF THE PLAGUE. stantinople are never put into quarantine, In the Revue Médicale, 1B1. Pariset brings while those from Egypt always are so. forward a new opinion on the object of em- M. Pariset maintains, that the best, if not in Egypt. He endeavours to show, the only, means of arresting the further proby statistical calculations, that the inhabi- gress of the plague, is the re-introduction of tants of this country possessed no other embalming in to the extent to which means of protecting themselves against the it was formerly We conclude this notice with stating, injurious effluvia of putrid animal substances, and that it was, consequently, not an that M. Pariset left Paris, at the end of last for Marseilles, in order to examine object of religion, as has hitherto been be-
or
sary for
,
plained,
balming
Egypt, adopted.
month,