STONE IN THE BLADDER 361 



action, or the already irritable, and perhaps eroded, mucous surface will 

 be excited to intlame and lead to renal complications and other untoward 

 results. To be effectual, therefore, a frequent and prolonged application 

 of the I'emedy is indispensable. 



The operation of injecting the bladder is clearly one which cannot 

 be entrusted to lay hands, and if carried out to meet the necessities of 

 the case by a qualified surgeon, must involve considerable outlay, to 

 say nothing of the trouble, risk, and loss otherwise sustained. Obviously 

 then the remedia lithontriptica becomes, for all practical purposes of 

 stone, a dead letter, and must be relegated to the limbo of exploded 

 fables. 



The Operation of Lithotomy. — Great and important as have been 

 the innovations and improvements in the course of the development of 

 human surgery during the past fifty years, it must be admitted that 

 operative measures of procedure in combating disease in the lower animals 

 have not kept pace with the tide of progress everywhere revealed in the 

 surgical treatment of man. Nor was it to be expected that animals, 

 whose material services constitute their real worth, could for economic 

 reasons be allowed those higher considerations in which everything is 

 subordinated to the maintenance of life. Before deciding upon the 

 operation of lithotomy a careful consideration should be given to every 

 feature of the case, and the chances of success and failure well weighed 

 in the balance. 



In tutored hands the operation may be said to be a fairly safe and 

 successful one under ordinary circumstances; but whoever undertakes it 

 must be prepared to encounter deviations and difficulties, as in all opera- 

 tions, and should command the necessary information and experience 

 by which they may be met and overcome. 



The very brief and general terms in which this operation is described, 

 and the summary manner in which it is dismissed by veterinary authors, 

 are not such as to throw much light on the modus operandi, and no 

 doubt it is for want of more precise and reliable information in this 

 connection that lithotomy in the lower animals is so little understood 

 and so seldom practised. 



Preparing for the Operation. — Preparing the patient for the 

 operation of lithotomy or lithotrity is in all cases more or less desirable. 

 It should ever be borne in mind that the aim and object of extracting a 

 stone is not merely the accomplishment of a surgical feat, but to preserve 

 life, and, what is equally imjjortant from an economic point of view, the 

 utility of the patient. Every means, therefore, tending to ensure success 

 should be fully considered and adopted. 



