Introduction to the catalogue of the collections of calculi of the bladder upwards of one thousand in number (besides foreign bodies) removed by operation.

  • Thompson, Henry, Sir, 1820-1904.
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Introduction to the catalogue of the collections of calculi of the bladder upwards of one thousand in number (besides foreign bodies) removed by operation. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    I lost no oiDportunity of seeking for tlie calculus when recently developed, and learned slowly, with surprise, how much more frequently it was to be found in the bladders of elderly men than I had been taught to expect. So far from the stone being more common in children than in adults, according to the universal belief at the period referred to, justified as it was by the records of hospital practice, I was soon in a position to affirm, and did so, that stone was more common among men of sixty years of age and upwards than at any other period of life. For let it be remembered that all existing records of practice, whether found in museums or reported by the operators themselves, from all sources previous to the middle of the present century, showed that half the total number of operations for calculus occurred in childhood and youth.^ The truth nevertheless was, that a very large majority of calculous cases was then, as now, to be found in persons above fifty years of age; but the fact was then unknown; the calcuH were simply overlooked, not being suspected to exist. And one obvious cause of the oversight is to be found in the truth of the axiom, that the early symptoms in elderly subjects are extremely slight—a rule with only a few exceptions—contrasting strongly with the marked and painful symptoms rarely absent in the young. Thus the slight irritation, scarcely felt unless con- siderable exercise is taken, was naturally attributed in elderly patients to commencing enlargement of the pro- state, to undue acidity of the urine, to ' irritation con- sequent on gout,' &c. &c. Hence examination of the bladder for calculus had usually been deemed for such ' See Appendix, page 39. B