THE INDIAN MEDICAL GAZETTE.
184
PILGRIM HOSPITAL, GTA.
A
CASE OP CALCULUS VESICiE.
By
C. M. Russell, M.D., Civil Medical
Bokhori?a strong,
temperate habits,
an
powerfully
Officer, Gya.
built man,
nged
40. of in-
floriculturist by occupation?sought aid
the Pilgrim Hospital on account of stone in the bladder ; and 011 the 20tlx August, 1871, I performed the lateral operation, and experienced no difficulty either in entering the bladder or in extracting the stone, which was of moderate size, weighed 6| drachms, and consisted of uric acid. As the man was much addicted to the bottle, it was found necessary to giro him an extra quantity of chloroform to induce a state of insensibility. The peculiar feature in this case was, that a few minutes after the operation an alarming hemorrhage took place, although there was scarcely any bleeding at all during the performance of the operation itself. The haemorrhage did not supervene until re-action from the effects of the chloroform had set in, and was probably caused by section of some large muscular branch of the internal pudic artery, and the relaxation produced through the influence of the anaesthetic. Tlio stone was isolated, and no undue force or roughness was used for its extraction. The patient felt a desire to micturate every time the bladder became distended with blood, and passed lnrge clots of scarlet blood, witli a gush at intervals of ten or fifteen minutes, some eight or ten times. Injections of a saturated solution of alum in cold water were at, first tried, but without success ; then, lumps of ice?which were fortunately obtainable?were introduced into the bladder and rectum, and placed over the pubes ; ice wa3 also given by the mouth ; but these measures failed to check the haemorrhage. At last, the lower part of the trunk was elevated by placing pillows benenth the man's buttocks, and gurrahs of cold water wore poured in a tJiin stream on to the pubes and region of the bladder from a height, and succeeded in stopping the haemorrhage. The patient was then made to take a mixture containing digitalis, opium, and gallic acid for twenty-fours hours, and no secondary haemorrhage supervened. ITe made an excellent recovery, and not a single bad symptom followed, although he was anything but a quiet patient, and would talk and ehat incessantly. The urine was voided by the natural passage on the tenth day, and the man left the hospital, cured, nineteen days after the operation. The haomorrhnge was so profuse and alarming, that I entertained the worst fears as to the result?fears which proved groundless, as the patient was none the worse for the loss of Wood. at
[August 1,
1872.
184
PILGRIM HOSPITAL, GTA.
A
CASE OP CALCULUS VESICiE.
By
C. M. Russell, M.D., Civil Medical
Bokhori?a strong,
temperate habits,
an
powerfully
Officer, Gya.
built man,
nged
40. of in-
floriculturist by occupation?sought aid
the Pilgrim Hospital on account of stone in the bladder ; and 011 the 20tlx August, 1871, I performed the lateral operation, and experienced no difficulty either in entering the bladder or in extracting the stone, which was of moderate size, weighed 6| drachms, and consisted of uric acid. As the man was much addicted to the bottle, it was found necessary to giro him an extra quantity of chloroform to induce a state of insensibility. The peculiar feature in this case was, that a few minutes after the operation an alarming hemorrhage took place, although there was scarcely any bleeding at all during the performance of the operation itself. The haemorrhage did not supervene until re-action from the effects of the chloroform had set in, and was probably caused by section of some large muscular branch of the internal pudic artery, and the relaxation produced through the influence of the anaesthetic. Tlio stone was isolated, and no undue force or roughness was used for its extraction. The patient felt a desire to micturate every time the bladder became distended with blood, and passed lnrge clots of scarlet blood, witli a gush at intervals of ten or fifteen minutes, some eight or ten times. Injections of a saturated solution of alum in cold water were at, first tried, but without success ; then, lumps of ice?which were fortunately obtainable?were introduced into the bladder and rectum, and placed over the pubes ; ice wa3 also given by the mouth ; but these measures failed to check the haemorrhage. At last, the lower part of the trunk was elevated by placing pillows benenth the man's buttocks, and gurrahs of cold water wore poured in a tJiin stream on to the pubes and region of the bladder from a height, and succeeded in stopping the haemorrhage. The patient was then made to take a mixture containing digitalis, opium, and gallic acid for twenty-fours hours, and no secondary haemorrhage supervened. ITe made an excellent recovery, and not a single bad symptom followed, although he was anything but a quiet patient, and would talk and ehat incessantly. The urine was voided by the natural passage on the tenth day, and the man left the hospital, cured, nineteen days after the operation. The haomorrhnge was so profuse and alarming, that I entertained the worst fears as to the result?fears which proved groundless, as the patient was none the worse for the loss of Wood. at
[August 1,
1872.
