The Operation of Lithotomy on Women, by Mons. le Cat. M. D. & F. R. S.

quatuor erant in sinistro pectore pro digitis, quinta vero cademque maxima dextrum deformabat pectus, pollicem recipiens. Quam itaque perversus sit ille, et detestandus tenellos infantes tractandi mos, satis ille frequens, ex supra dictis facile patebit, spero, cuique. Si vero ad illos perveniat hæc observatio, quod valde optarem, qui infantum curas gerunt, plures, puto, a vitio illo immunes praestari in posterum poterunt homines, ne prima ætate male tractati hoc vel alio modo non minus cauto, vel desfigurentur; vel et tabe, vel alio morbo inde orto consumantur. Simillimam narratae observationem feci nupera hyeme in puella duorum annorum. Et uti jam monui in vivis ctiam corporibus animadverti similia. Cum Rachitide cæteroquin minime confundenda est deformitas ista. Dabam Cassellis Jan. 31. 1747. Joh. Jac. Huber. III. The Operation of Lithotomy on Women, by Mons. le Cat. M.D. & F.R.S. Translated from the French by T. S. Read April 6. THE lateral Way of cutting for the Stone, which I have used on Men since 1732, naturally led me, in the Year 1735, to cut the Widow Neel, a Farmer near Yvetot in the Pais de Caux in the same manner, as has been seen in the Observation. In this Operation the common grooved Staff served me as a Director; and having made the Incision, on the left Side of the Urethra, with the strait grooved Knife, which I used that Year in cutting Men, I withdrew the grooved Staff, and introduced the Groove of the Knife. Immediately after this Operation, I shorten'd the Work, by reducing the three Instruments to two. For that Purpose I contrived to add to the common Gorget AA, Fig. 1. and 2. Tab. 1. a grooved Staff BB. After placing and tying the Patient in the same manner as for cutting Men, I at once introduce into the Urethra the End B of the Gorget, which constitutes the grooved Staff, I turn the Groove towards the Patient's left Buttock: On this Groove I push the Knife (Urethro-cistitome) Fig. 3. which is not grooved, nor so broad as that which I made use of in 1735 on the Widow Nel. Having laid open the Neck of the Bladder, I lay aside the Knife, and thrust the Gorget farther into the Bladder; for Example, as far as C. Then I pass the Fore-finger on the Gorget into the Bladder, to dilate the Neck; which done, I introduce the Gorget as far forward as is necessary, and on it the Forceps. The rest of the Operation is performed as on Men. The first of the Sex, whom I cut in this last Method, as appears by my Journal, is Magdalen le Marchand of the Pais de Caux, aged 22, cut in May 1738. I extracted a large Stone from her, and she was cured in ten Days. Since that time I have constantly practised this Method, which has succeeded perfectly well. When the Stones were little, the Patients were cured in a few Days: But here is one, whose speedy Cure has somewhat surprising in it; inasmuch as I really believe it the only one which has happen'd so. Mary Mary le Comte of Diepdal near Rouen, aged 12, cut the 24th of May 1740, had a Stone of a middling Size. In three Hours she retain'd her Urine, so as not to discharge it but voluntarily. I thought it was the pretty 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 I was mistaken. There was not the least Suppuration. Mary le Comte perform'd 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 third Day, in good Health, without any Accident supervening. At the same time that I was labouring to improve the Manner of cutting Women, and shorten the Operation, I contrived another Gorget (Fig. 4.) which, besides the grooved Staff of the former, contain'd within it the cutting Instrument, which was to make the Incision or Enlargement; that is to say, the three Instruments in one: And this Instrument was attended with this Advantage, that it could serve for Men as well as Women. One Hand is sufficient to perform the Operation with this Instrument; but as the other Hand became in a manner useless; and moreover, as it is probable that a Person can better depend on an Incision made directly with the Hand, than on those which are made by Machines or Springs. I have not hitherto used this Instrument; tho' possibly the Habit I had contracted of using the others has some Share herein. However that be, I have annexed the Figure and Description of this Gorget, that those who like it, may make use of it. Tab. I. Fig. 4. Explanation of the Figure of the Gorget, which Mr. le Cat calls Gorgeret Urethro-cistitome. A, A Ring, for passing the middle Finger of the right Hand, which grasps the Handle G. B, Another Ring which is slid by the Fore-finger towards d, to push the Blade ab, out of the Groove EF. The Figure represents the Instrument in the State in which it is at the very Instant when the Incision is made into the Neck of the Bladder. The same Fore finger draws the Piece B back towards A, when the Operator intends to make the Blades return into the Groove F; where they lie hid, while he introduces the Instrument from D, as far as If into the Urethra. The Groove FE is closed or covered from d to e, in order to secure the Pieces a, b, c, d, e, in Situation. The Pins, which bind the Hinges a, b, c, must not be in the Center of the Pieces, but as they are expressed in the Figure; where b is pretty near the outer Edge, and the other two a, e, on the opposite Side; to the end that, when the Ring B is thrust forward, the Hinge b may bend, and issue out of the Groove F, by making the Angle abc.