(?orresponi)mee. LITHOTOMY STATISTICS. To the Editor of the
Sir,?Several
"
Indian Medical
letters have
lately appeared
Gazette." in the Indian
Medical Gazette on Lithotomy Statistics in India, comparing the mortality of lithotomy with lithotrity and drawing attention to the high mortality in these operations in India. As far as my experience goes, I do not think the first operation so serious a one as is supposed. I have performed this operation (lithotomy) some 70 times, when I was Civil Surgeon in the N. W. Provinces, and only lost two cases, one of which occurred in a weakly sickly child that I was at the time averse to operate on, but I yielded against my better judgment at the earnest solicitations of the child's parents, who had come from a distance of some 50 miles to have the boy attended to. All these 70 cases occurred in adults, children and infants of both sexes ; but in the two or three cases in females, I dilated rapidly and supplemented the dilating process by a slight touch of the knife ; as far as I remember now, I had only to do this latter in one or at the least two cases, but I have unfortunately lost my notes of the cases. With lithotrity I have had no experience, but should imagine that for natives it is far and away the one that suits their dispositions the least, impatient as they are of remaining for any " Surgeonlength of time in hospital ; this is alluded to by Major" in his letter published on the 1st January number of the Gazette, and to which I most heartily agree, as well as to his remarks about lithotrity in females ; I would, as above stated, always prefer rapid dilatation with, if necessary, unilateral or bilateral urethrotomy. Since leaving the N. W. Provinces and coming here to Assam, I have never heard or met with a case of stone in the bladder, nor, as any other medical man, done so either, as far as I am aware. "
Surgeon-Major"
in his letter says,
"
Lithotrity
in a very
large proportion of adult cases of stone is admittedly the most
safe and the most successful operation, and the one par excellence to be employed." This, with all due deference to " Surgeon-Major." is a matter of opinion, and from my limited experience I should myself much prefer lithotomy to lithotrity in most cases; certainly in those amongst natives. I think there is sure to be much more irritation set up. both general and local, by the latter operation than the former. Yours obediently, T. DO. Partridge.
Debnu/arJt, Assam, 25th January 1SS0.
Sir,?Several
"
Indian Medical
letters have
lately appeared
Gazette." in the Indian
Medical Gazette on Lithotomy Statistics in India, comparing the mortality of lithotomy with lithotrity and drawing attention to the high mortality in these operations in India. As far as my experience goes, I do not think the first operation so serious a one as is supposed. I have performed this operation (lithotomy) some 70 times, when I was Civil Surgeon in the N. W. Provinces, and only lost two cases, one of which occurred in a weakly sickly child that I was at the time averse to operate on, but I yielded against my better judgment at the earnest solicitations of the child's parents, who had come from a distance of some 50 miles to have the boy attended to. All these 70 cases occurred in adults, children and infants of both sexes ; but in the two or three cases in females, I dilated rapidly and supplemented the dilating process by a slight touch of the knife ; as far as I remember now, I had only to do this latter in one or at the least two cases, but I have unfortunately lost my notes of the cases. With lithotrity I have had no experience, but should imagine that for natives it is far and away the one that suits their dispositions the least, impatient as they are of remaining for any " Surgeonlength of time in hospital ; this is alluded to by Major" in his letter published on the 1st January number of the Gazette, and to which I most heartily agree, as well as to his remarks about lithotrity in females ; I would, as above stated, always prefer rapid dilatation with, if necessary, unilateral or bilateral urethrotomy. Since leaving the N. W. Provinces and coming here to Assam, I have never heard or met with a case of stone in the bladder, nor, as any other medical man, done so either, as far as I am aware. "
Surgeon-Major"
in his letter says,
"
Lithotrity
in a very
large proportion of adult cases of stone is admittedly the most
safe and the most successful operation, and the one par excellence to be employed." This, with all due deference to " Surgeon-Major." is a matter of opinion, and from my limited experience I should myself much prefer lithotomy to lithotrity in most cases; certainly in those amongst natives. I think there is sure to be much more irritation set up. both general and local, by the latter operation than the former. Yours obediently, T. DO. Partridge.
Debnu/arJt, Assam, 25th January 1SS0.
