SITAPUR DISPENSARY.
case"^
of
stone
in
the
female
BLADDER.
Reported by Assistant-Surgeon Nobin Chunder Dutt. Hansi, a Hindoo woman, aged about 45, applied for treatment at the Sitapur Sudder Dispensary on the 29th
July 1,
1878.]
A MIRROR OF HOSPITAL PRACTICE.
She complained of great pain in the and of difficulty of micturition. She further stated that on an attempt being made to pass water, something seemed to glide down and obstruct the passage. Suspecting the presence of stone in the bladder, I passed a female catheter into it and found my suspicion verified?a stone was distinctly felt. Previous history.? Stated that about^ 2 years ago she noticed a sediment very much like sand in her urine, and once she passed a small bit of gravel; later on she commenced suffering from agonising pain in the bladder, and difficulty of micturition ; urine was passed in drops with much straining ; it was often mixed with blood; sometimes passage of urine stopped altogether. Condition when admitted.? Countenance pale and expressive of suffering ; body emaciated ; pulse weak and small ; lies on her back with her legs drawn up ; the slightest attempt to change her position is accompanied with severe pain ; clothes wet and smelling of stale urine. Is constantly moaning. December Last.
hypogastric region,
Operation?
On the morning of the 3rd January she was placed under chloroform, and Dr. Ellis attempted to crush ihe stone ; but, as the operation took time, the patient being weak and a cousiderable time under chloroform,it was thought ad vis able to extract the stone by enlarging the urethra ; an incision half inch long was accordingly made downwards and outwards on the left side, and the stone extracted by means of a pair of ordinary lithotomy forceps. The stone was about the size of a pigeon's egg, and weighed a little more than 6 drs. The patient took rather a long time in recovering from the effects of chloroform, her pulse sank and respiration became irregular for a time, but she came round ulti-
mately.
An iron suture was applied to keep the divided parts in apposition, and a female catheter being passed into the urethra and kept in situ, the wound was dressed up with carbolic acid and the dressing secured by a T.
bandage.
After
treatment.?
A full dose of tincture of opium was administered shortly after the operation, and half a gr. of opium combined with gr. iii. of quinine was subsequently ordered to be given thrice daily. The patient progressed favourably. On the fourth day after the operation she had a touch of dysentery which yielded to a dose or two of ipecac, in combination with the above. She was then treated with general tonics till the 17th January, when she was discharged cured, with perfect control over her bladder. \
?
187
case"^
of
stone
in
the
female
BLADDER.
Reported by Assistant-Surgeon Nobin Chunder Dutt. Hansi, a Hindoo woman, aged about 45, applied for treatment at the Sitapur Sudder Dispensary on the 29th
July 1,
1878.]
A MIRROR OF HOSPITAL PRACTICE.
She complained of great pain in the and of difficulty of micturition. She further stated that on an attempt being made to pass water, something seemed to glide down and obstruct the passage. Suspecting the presence of stone in the bladder, I passed a female catheter into it and found my suspicion verified?a stone was distinctly felt. Previous history.? Stated that about^ 2 years ago she noticed a sediment very much like sand in her urine, and once she passed a small bit of gravel; later on she commenced suffering from agonising pain in the bladder, and difficulty of micturition ; urine was passed in drops with much straining ; it was often mixed with blood; sometimes passage of urine stopped altogether. Condition when admitted.? Countenance pale and expressive of suffering ; body emaciated ; pulse weak and small ; lies on her back with her legs drawn up ; the slightest attempt to change her position is accompanied with severe pain ; clothes wet and smelling of stale urine. Is constantly moaning. December Last.
hypogastric region,
Operation?
On the morning of the 3rd January she was placed under chloroform, and Dr. Ellis attempted to crush ihe stone ; but, as the operation took time, the patient being weak and a cousiderable time under chloroform,it was thought ad vis able to extract the stone by enlarging the urethra ; an incision half inch long was accordingly made downwards and outwards on the left side, and the stone extracted by means of a pair of ordinary lithotomy forceps. The stone was about the size of a pigeon's egg, and weighed a little more than 6 drs. The patient took rather a long time in recovering from the effects of chloroform, her pulse sank and respiration became irregular for a time, but she came round ulti-
mately.
An iron suture was applied to keep the divided parts in apposition, and a female catheter being passed into the urethra and kept in situ, the wound was dressed up with carbolic acid and the dressing secured by a T.
bandage.
After
treatment.?
A full dose of tincture of opium was administered shortly after the operation, and half a gr. of opium combined with gr. iii. of quinine was subsequently ordered to be given thrice daily. The patient progressed favourably. On the fourth day after the operation she had a touch of dysentery which yielded to a dose or two of ipecac, in combination with the above. She was then treated with general tonics till the 17th January, when she was discharged cured, with perfect control over her bladder. \
?
187
