1831. J C 441 ] 



MONTHLY REVIEW OF LITERATURE. 



PttlNCIPLES OF LiTHOTRITY. By BaRON HeURTELOUP, DoCTOR OF THE 



Faculty of Medicine, Paris. 



Lithotomy, or cuttiny for the stone, is an operation comparatively modern, 

 but though frequently accomplished with success, it is always hazardous, and 

 in a large proportion of cases attended with fatal results. But the knife is the 

 favourite instrument with English surgeons. Something like vanity enters into 

 their dexterous use of so formidable an instrument ; and the}' will not readily 

 relax their hold. On the face of it, Lithotrity — that is, the breaking and 

 crumbling of the stone by the means of instruments introduced through the 

 urethra, is the more obvious and desirable mode of cure. The source of the 

 disease is thus accessible by one of nature's own passages, and not of man's 

 forcible entry. It is the difference between quietly opening the door of a house, 

 and burglariously breaking in ; and carries with it its own recommendation. 

 It is true lithotrity has been abandoned, on consideration for what appeared the 

 better process — the more direct and violent one ; but that is no proof of its su- 

 periority. Lithotrity may have been managed in a bungling manner ; but 

 modern ingenuitj% and the delicacy with which the necessary instruments can 

 now be manufactured, might long ago, had surgeons persevered, have remedied 

 all defects. Instead of this, the attention of the medical world has been turned 

 from it, and directed almost exclusively to the perilous knife. The art and the 

 use of it have doubtless been improved ; but no approaches have been made, or 

 can hope to be made, Jx>-p^rfect security. In this state of things We welcome 

 this powerful pubFication of Baron Heurteloup — a French gentleman, who has 

 turned his mind to the improvement of lithotritic instruments for some years 

 past, and who is now settled in London for professional practice. The book is 

 obviously the production of a man who enters zealously into the subject, and is 

 thoroughly familiar with its details, and who writes, moreover, in a manner 

 "intelligible to the meanest capacity." It cannot fail of arresting attention. 

 Patients will force surgeons to turn to it. The dread of lithotomy is general, 

 and the facilities and safety of lithotrity will strike patients forcibly — it will be 

 difficult, when once this book becomes known, to persuade them to submit to 

 the knife. 



Into the particular merits of the baron's improvements, we cannot here, of 

 course, enter ; but the following considerations are worth listening to : — " Litho- 

 tomy requires to be performed in a favourable season ; lithotrity may be per- 

 formed at all times, with equal chance of success. The former requires that the 

 patient should remain in bed for a month or six weeks after the operation ; the 

 latter needs no confinement, and often allows the patient to pursue his usual 

 avocations. Lithotomy requires the patient to be kept on a rigid diet ; while 

 he who undergoes lithotrity is only moderately restricted ; — the recovery is often, 

 in the former case, very tedious ; whilst, in the latter, it is effected at once. 

 Lithotomy often produces serious accidents — such as impotence, incontinence of 

 urine, and urinary fistuiie ; lithotrity, from its nature, cannot cause any of these 

 consequences. The former, whatever may be the means employed, aiwaj's 

 requires a large and deep incision ; the latter requires none. Lastly, lithotomy 

 may cause almost instant death, from hosmorrhage ; lithotrity cannot, under any 

 circumstances, produce such a termination." 



The History of Engmsh Dramatic Poetry, &c., dy J. Payne 

 Collier, Esq. 3 vols, 12mo. 



It would be difficult to point out, among the Origines of art or literature, 

 one more involved in obscurity than that of the English drama ; nor would it 

 be easy to decide which has most contributed to retard the clearing away of 

 that obscurity — inihjlcnce, ignorance, or arrogance. The general tone of com- 

 intnUitors and critics has been — we have done all that can be done — we have 



M.M. \nr S<rir.v.—yni.. XII. No. 70. 2 O 



