Stone in the bladder in connection with enlargement of the spleen / by Charles Williams.

  • Williams, Charles.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Stone in the bladder in connection with enlargement of the spleen / by Charles Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    12/16
    1861 I assisted a medical friend with a troublesome case of stone. The man, aged fifty-four, was corpulent and asthmatic. Three years previously an ineffectual attempt had been made to do lithotrity. The stone Avas broken, hut not removed. The man continued to suffer, and had constant and great bladder irritation and cystitis. Two large stones Avere removed. The operation Avas tedious from repeated slippings of the forceps. There Avas free but not serious haemorrhage. Iso plug Avas used. The patient died tAvo days after the operation. The prostate Avas freely divided. The bladder Avas contracted; the mucous membrane thickened and congested; the muscular coat thickened. The ureters, pelves, and tubes of the kidneys Avere much dilated. The spleen Avas of an enormous size—nearly as large as the liver. The next case, which occurred in 1866, Avas that of a gentleman aged sixty-four, a florid, almost purple-faced gouty man. The stone Avas removed by median lithotomy; the operation Avas easy and quick, and no bleeding occurred at the time. In a few hours haemorrhage came on, apparently from the prostatic veins ; it did not escape externally, but filled the bladder, and clots were frequently extruded. It ceased in tAventy hours ; the urine then became clear, and he seemed in every way doing Avell for four days. On the fifth day he ate an indigestible meal ; this Avas folloAved by oppression, and in a feAV hours by a sharp rigor and perspiration ; rigors folloAved every day or tivo. He became delirious, and died a fortnight after the operation. At the post-mortem examination the bladder Avas seen to be healthy ; the mucous membrane pale; the parts about the prostate rather congested. Ho pus Avas found anywhere. The kidneys Avere large and congested. There Avere two or three small stones in one, and some pyelitis. The liver Avas large and very congested ; the spleen four or five times its normal size, tinged Avitli blood, soft, and easily lacerable.