Proceedings of the Royal Imtitution, 391 



discoveries, may be found scattered through centuries, and some of 

 them belong to very early tune : for so long as men have been in- 

 tolerant of pain, so long must they have attempted to mitigate the 

 tortures of that most dolorous malady, stone in the urinary bladder ; 

 and long before even a thought of cutting into the bladder would 

 have been suggested, repeated efforts must naturally have been made 

 to void the calculus through the urethra ; but to effect this, when the 

 stone is large, it must be broken, and to break it, straight instru- 

 ments must be passed through a curved passage; two preliminary 

 circumstances which have baffled the ingenuity of surgeons until the 

 present day. The ignorance of the ancients of human anatomy 

 would seem to have led them nearer to one of these points than the 

 comparative proficiency of the modems ; for they, unconscious of 

 the curves of the urethra, used straight sounds, a practice which has 

 been generally condemned, and even the possibility of which has, 

 with some few exceptions, been, till very lately, most strenuously 

 denied. The greatly curved sounds and catheters have, however, for 

 many years, been lessening their sweeps, and a straight rod, with a 

 quadrant curve at its extreme, is certainly the most efficient for exa^ 

 mining the contents of the bladder. As to the destruction of the 

 stone in the bladder, by means of instruments passed, not through 

 the urethra, but through the perineum, so that it might be voided 

 piecemeal, the plan is so ancient, that the word lithotomy ^ which, in 

 truth, signifies cutting the stone^ was thence derived, although it has 

 since been applied to the operation of cutting the bladder for the 

 purpose of extracting the stone entire, which otherwise might rather 

 have been termed cystotomy ; and as to the injection of the bladder, 

 and the dilatation of the urethra, so that small stones might be ex-r 

 tracted, or washed through its enlarged canal, the practice has never 

 been lost sight of, and not unfrequently employed. But ancient as 

 these principles of lithotrity undoubtedly are, they were practically of 

 as little use for the removal of urinary calculi as if they had never 

 been known ; nor was it till the present day that surgery could boast 

 their efficient union. 



Ages have succeeded ages, during which the attention of sur- 

 geons has chiefly been directed to the improvement of the operation 

 of cutting for the stone, which has indeed been so far perfected, that 



