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At this time, on sounding the man, it was found that he had stone; this was removed by lateral operation, and was found to weigh 2 1/4 ounces, having for its nucleus a piece of bone about 1/2 inch long. Dougherty reports the operation of lithotomy, in which the calculus removed was formed by incrustations about an iron bullet.
Hunter mentions a native Indian, a resident of Coorla, who had introduced a bullock's horn high up into his abdomen, which neither he nor his friends could extract. He was chloroformed and placed in the lithotomy position, his buttocks brought to the edge of the bed, and after dilatation of the sphincter, by traction with the fingers and tooth-forceps, the horn was extracted.
Galabin had a case of ovariotomy performed on a woman in the sixth month of pregnancy without interruption of pregnancy; Potter had a case of double ovariotomy with safe delivery at term; and Storry had a similar case. Jacobson cites a case of vaginal lithotomy in a patient six and a half months pregnant, with normal delivery at full term.
Among this class we read of the Philoantropos major and minor, the Justinum, the Usina "approved by many wise men of Babylon and Constantinople," the Lithontripon and the "Pulvis Eugenii pape," with numerous others. Rather curiously and suggestively no mention is made in this immediate connection of the technique of lithotomy.
As soon as that was known, the extirpating of special clusters of thoughts became merely a question of mechanical difficulties to be overcome, merely a nice problem in surgery, and not more complex than many which my brethren have solved in lithotomy and lithotrity, for instance."
Duncan cites an instance of epilepsy connected with vesical calculus that was cured by lithotomy. Museroft mentions an analogous case. Greenhow speaks of epilepsy arising from an injury to the thumb. Garmannus, early in the eighteenth century, describes epilepsy arising from fright and terror. Bristowe in 1880, and Farre speak of similar instances.
According to Ashhurst, the most remarkable case on record is that of the aged Chief Justice Marshal, from whose bladder Dr. Physick of Philadelphia is said to have successfully removed by lateral lithotomy more than 1000 calculi. Macgregor mentions a case in which 520 small calculi coexisted with a large one weighing 51 ounces.
This saw is an old invention, perhaps as old as Hippocrates, and may be seen figured in the "Armamentarium Chirurgicum" of Scultetus, or in the Works of Ambroise Pare. Dr. Clark is said to have received a diploma before he came, for skill in lithotomy. He loved horses, as a good many doctors do, and left a good property, as they all ought to do.
On the battlefield men have amputated one of their own limbs that had been shattered. In such cases there would be little pain, and premeditation would not be brought into play in the same degree as in the case of M. Clever de Maldigny, a surgeon in the Royal Guards of France, who successfully performed a lithotomy on himself before a mirror.
In this we detect a taint of the popular belief in the philosopher's stone and the magic elixir of life, his belief in which have been stoutly denied by some of his followers. He did admit, however, that one operation alone was perhaps permissible lithotomy, or the "cutting for stone."
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