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Show 25% Hasnonnmer. or Lzrnororsr. of the stone smooth, and the other rough, it founds a strong presumption that there are other stones. We must recollect that it is most dangerous to leave a stone in the bladder after the operation of lithotomy; for the inflammation produced by the incision is increased by the continued irritation of the stone, and will destroy the patient; whereas, if relieved from the irritation of the stone, the parts suffering less from the operation, would soon recover. If the stone is broken, we apply the parts together, and see that we have got them all; and when the softer surface has broken down under the forceps, we must be careful to wash the pieces away with the syringe, or bag and pipe, by injecting several times into the bladder ; and, with the finger, H sustain... examining that no considerable portion remains. In museums, I have certainly seen urinary calculi, lying in sacs formed in the coats of the bladder. But they must be very rare. I have never chanced to see any thing like this in 255 patient is carried to bed. Under him the cloths are placed as for a woman after child-bed. Now, an opiate is usually givems. The urine is, for the first fortnight, passed through the wound. Often, however, on the second and third day, it is passed by the urethra. This is merely owing to the tumefaction of the rising inflammation, and it is better when it passes only freely through the wound. Towards the end of the fortnight, the urine should pass by the urethra, and in a per. fectly successful operation, the parts should be healed in three weeks. The violence of the operation, without hamorrhagy or inflammation, I have seen kill the patient in about ten hours. The continued pain and violence of the operation is too much for the nervous system to bear, and the powers of life are destroyed before they are assaulted through the vascular system. The first rising of high inflammation, is a period of danger "mm . operation. Indeed, these sacculated stones must give very little inconvenience, and not call for operation. But I have often seen errors and mistakes lead the surgeon to the comic tion that his difficulties proceeded from something of this kind. That stories may adhere, I know; but this is the nature of that adhesion. Mr. Lynn, in performing this operation, laid to life. When the system is suffering directly under the pain and violence of the operation, there is an incessant vomiting or hickup.‘ The warm bath, with large opiate clysters, I conceive to be our chief resource. Though I know that when the bowels can be moved in that low irritability of the stomach, it relieves this most alarming symptom. hold of the stone, and brought it down with some difficulty; When the inflammation does actually attack in an alarming but with great uneasiness, he found that he had inverted the bladder, and that the stone adhered to it. He turn- ed off the stone from the granulation on the inner coat of the bladder, as the stone of a ripe peach is turned out of the pulp, and reduced the bladder. degree, we must be resolute in bleeding repeatedly. We blister the belly largely, use the warm bath, and gently move the bowels, give blisters, Sec. He carried the stone HfEMORRHAG Y. to MrsHunter, as a proof against his opinion, that living parts could not attach themselves to inanimate matter. Mr. Hunter gave it as his opinion, and convinced him that this was a stone formed on the fungus excrescences of the bladder, and, in consequence of the disease, not a stone adhering to the blad~ der. A bit of oiled lint is put upon the lips of the wound, the thighs are bound slightly together with a soft tape, and £115 We ought to turn our attention to the quantity of coaguiated blood which lies under the table before dressing the patient. The question that naturally occurs is this, whether is *‘ The dressing is very simple, all our care being to dress mildly, and to see that no lodgmeut ot‘urine or matter be allowed by the side ofthc recturn wom M09917ll . |