370 
A CASE OF LITHOTOMY. 
Shortly after being put into the box, an elastic tube was intro- 
duced into the bladder, and secured by tapes, with the external 
orifice pointing downwards, and, as the pulse was feeble, and a 
slight chill had come upon him, I ordered a little warm wine and 
water, which soon rallied him, and shortly after he took a little 
mash. In the evening he began to water through the tube, and 
the wound had become a little swollen and inflamed, accom- 
panied with a slight discharge of a bloody serous fluid. About 
II p.m., he had another rigor, which was again checked by a 
little warm wine and water. During the night he was watched, 
and appeared to be going on well ; but in the morning was again 
attacked with a chill, from which, after taking a little more wine 
and water and hand-rubbing, he seemed relieved. About noon, 
however, he began to droop ; the extreme parts of the body be- 
came exceedingly cold ; the pulse very feeble ; and he gradually 
sunk towards evening, when he died. 
On examination on the following day, no traces of inflammation 
of the peritoneum or pelvic viscera were found ; and on making a 
section of the pelvis to see the parts implicated in the operation, 
it was found that no injury had been inflicted in the peritoneum 
and rectum, which were entire. 
The interior of the bladder was rough and flocculent ; the ureters 
very much enlarged and thickened, and they seemingly had acted 
as accessory bladders. — The tumour above referred to was, as 
suspected, melanotic. It surrounded the whole of the lower and 
right side of the neck of the bladder, and extended forwards along 
the greater part of the right side of the body of the bladder; but 
it had not been injured during the operation. When removed 
from its connexions, it measured seven inches in its long diameter 
and four inches in its short, and weighed twenty-four ounces. 
No other morbid appearances could be found ; and it appears to 
me, therefore, that death resulted from the prostration produced 
upon the previously weakened constitution of the animal. 
The larger portion of the stone, which was removed entire, 
weighed seven ounces and three quarters, and, from the consi- 
derable portion which had been broken off by the attempts to 
crush it, it could not have been less than ten ounces. As yet it 
has not been analysed, but I will communicate the result as soon 
as it has been done. 
