650 PHILOSOPHICAL TRANSACTIONS. [anNO I749. 



The Operation of Lithotomy on Women. By M. le Cat, M.D., F.R.S. 

 N° 492, p. 97. Translated from the French by T. S. 



The lateral way of cutting for the stone, which M. le Cat used on men since 

 1732, naturally led him, in the year 1735, to cut the widow Neel, a farmer 

 near Yvetot in the Pais de Caux, in the same manner. In this operation the 

 common grooved staff served as a director ; and having made the incision, on 

 the left side of the urethra, with the straight grooved knife, which he used that 

 year in cutting men, he withdrew the grooved staff", and introduced the groove 

 of the knife. 



Immediately after this operation, he shortened the work, by reducing the 3 

 instruments to 2. For that purpose he contrived to add to the common gorget 

 AA, fig. 11 and 12 pi. 11, a grooved staff bb. After placing and tying the pa- 

 tient, in the same manner as for cutting men, he at once introduced into the 

 urethra the end b of the gorget, which constitutes the grooved staff, he turned 

 the groove towards the patient's left buttock: on this groove he pushed the knife, 

 fig. 13, which is not grooved, nor so broad as that which he used in 1735 on 

 the widow Neel. Having laid open the neck of the bladder, he laid aside the 

 knife, and thrust the gorget farther into the bladder ; for example, as far as c. 

 He then passed the fore-finger on the gorget into the bladder, to dilate the neck; 

 which done, he introduced the gorget as far forward as is necessary, and on it 

 the forceps. The rest of the operation was performed as on men. 



The first of the sex, whom he cut in this last method, as appears by his jour- 

 nal, was Magdalen le Marchand of the Pais de Caux, aged 22, cut in May 

 1738. He extracted a large stone from her, and she was cured in 10 days. 



Since that time he constantly practised this method, which had succeeded 

 perfectly well. When the stones were small the patients were cured in a few 

 days : but the following is one, whose speedy cure has somewhat surprising in 

 it ; as he really believed it the only one which had happened so. 

 .' Mary le Comte of Diepdal near Rouen, aged 12, cut the 24th of May 1740, 

 had a stone of a middling size. In 3 hours she retained her urine, so as only 

 to discharge it voluntarily. M. le Cat thought it was the common effect of the 

 inflammatory swelling, which frequently happens after the operation ; and that 

 the suppuration would soon relax these parts, and open the wound, but he was 

 mistaken. There was not the least suppuration. Mary le Comte performed all 

 the functions of this organ, as usual ; and being tired of the bed, to which she 

 was confined against her will, she got up the 3d day, in good health, without 

 any accident supervening. 



At the same time that he was labouring to improve the manner of cutting 

 women, and shorten the operation, he contrived another gorget, fig. 14, which, 

 besides the grooved staff of the former^ contained within it the cutting instru- 



