161 



until an extensive series of observations can be gathered from the 

 different sections of the country, no accurate knowledge on the sub- 

 ject will be obtained. Deprived as we thus are of any precise in- 

 formation on the matter, it may not be amiss to state, as the general 

 impression of medical men among us, that calculus is rare in New 

 England, more common in the Middle and Southern States, and 

 that it is much more frequently met with in the Valley of the Mis- 

 sissippi than in any other portion of the country. Negroes are 

 thought to be rarely the subjects of it, while in Canada it is said to 

 be not uncommon. For the cure of stone, the cutting operation 

 still continues to be that mostly resorted to, and the lateral operation 

 with the gorget is believed to be the procedure most commonly em- 

 ployed. Nor is this to be wondered at, when the prepossession in 

 its favour, derived from our earliest teachers, joined to the ease and 

 rapidity with which the operation is done, and the fair results which 

 usually follow it, are considered, added to which the unprecedented 

 success that continues to be furnished by it in the hands of the emi- 

 nent Professor of Surgery, in the Transylvania University, tends 

 perhaps not a little still to popularize it among American surgeons. 



In the last account* of the practice of Dr. Dudley which has 

 reached us, it is stated that up to the beginning of 1846 he had 

 operated upon 185 cases of stone, of which number 180 are re- 

 ported as successful. This remarkable result, according to Dr. 

 Bush, cannot be attributed to any selection of cases on the part of 

 the operator, since out of 188 subjects presented to him, 185 were 

 cut. Dr. B. who furnishes this report, ascribes these results to 

 the thorough preparation of the general system made by Dr. Dudley, 

 preparatory to the operation, an account of which was detailed some 

 years since, in a paper published by him in the Transylvania Journal, 

 and which we can only here refer to. 



From communications that have been made to the committee, it 

 appears that Dr. Marsh, of Albany, has operated by the lateral 

 method seven times, all of which were successful. 



Dr. Mettauer, of Virginia, states that he has operated by litho- 

 tomy on seventy-three cases of calculus, two of which proved fatal. 

 One from prostatic hemorrhage, and the other from the occurrence 

 of spasm of the ileum. 



Dr. Jno. C. Warren has operated upon thirty cases, of whom two 

 died; one of these lost his life by an error in diet, the other had a 



* Western Lancet, 184G. 



