Some points in practical surgery suggested by the study of the life and work of John Hunter : being the Hunterian lecture delivered before the Hunterian Society of London, February 26, 1902 / by Reginald Harrison.

  • Harrison, Reginald, 1837-1908.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Some points in practical surgery suggested by the study of the life and work of John Hunter : being the Hunterian lecture delivered before the Hunterian Society of London, February 26, 1902 / by Reginald Harrison. 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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    In persons suffering from much enlargement of the prostate and catheter dependence, complicated with stone in the bladder, after litholapaxy has failed once or perhaps twice, to prevent recurrence of the latter, suprapubic cystotomy will have still further claims for consideration, not only because it permits of the removal at one opera- tion of the stone, but a contributing cause of it, as well as the catheter dependence, which so frequently co-exists or arises under these circumstances. I will proceed to illustrate the employment of prostatectomy by the narration of a few cases, and to show what was thus removed. Case i,—The following case may be taken as illus- trating—not any difficulty connected with the removal of stone from the bladder by crushing or litholapaxy— but two conditions favourable to the formation and re- currence from time to time of phosphatic stone when an enlargement of the prostate is present. These were (i) the necessity existing for the permanent use of the catheter which implied the suspension of the voluntary power of urine-expulsion and whatever else the bladder contained ; and (2) a specially foul state of the residual urine which co-existed and supplied a material for stone formation. The case further illustrates how the removal of the obstruction thus caused by the prostate ended these two conditions. A professional man, aged 55, seen with Sir R. Douglas Powell, in April, 1899, with symptoms of stone in the bladder for which he was sounded. A stone was felt lying behind a prominent prostate. 1 removed the former by litholapaxy, the fragments weighing 296 grains of oxalate and phosphatic stone. The patient, previous to the operation, had been largely dependent on his catheter for a year and it was hoped that the removal of the