Lithotomia Douglassiana: OR, An Account of a New METHOD of making the High Operation, in order to extract the Stone out of the Bladder.

Which is much easier to the Patient, much sooner done by the Operator, and the Cure much more certain, than after any of the other Methods now in Use.

By which also, several of the most dismal Consequences of the common Operations are entirely prevented, such as Incontinency of Urine, Impotency, Fistula's, &c.

Invented and successfully perform'd BY JOHN DOUGLAS, Surgeon.

Non est ut fidas his, qui merè audita recensent: Fidas autem illis serio, qui ex Experientia propria loquuntur.

LONDON: Printed for Tho. Woodward, next Door but one to Temple-Bar. MDCCXX.

Lithotomia Douglassiana: OR, An Account of a NEW METHOD of making the HIGH OPERATION, in order to extract the Stone out of the Bladder, &c.

IN this new Operation, I cut on the lower Part of the Belly. In the common Operations, viz. Cutting on the Staffe, and cut­ting on the Gripe, they cut on the Perinaeum, i. e. between the Testicles and Fundament.

This Section is call'd by Authors, The High Operation, or Hypogastrick Se [...]tion.

I have hitherto only [...]et with three, that ever pretended to have made it: The first of whom is Peter de Franco of Turriers in France, of which he gives the following Account in his Treatise of Hernio's, (at the End of the 33d Chapter, Page 139) publish'd at Lyons in the Year 1561, in these Words: "Histoire, Je reciteray ce que une fois m'est advenu voulant tirer une pierre a un enfant de deux ans ou environ: auquel ayant trouué la pierre de la Grosseur d'um aeuf de poulle, ou peu pres, je fey tout ce que je peu pour la mener bas: & voyant que je ne pounoye rien avancer partous mes efforts, avec ce, que le patient estoit merueillcusement tormenté, & aussi les Parens desirans qu'il mourust plustost que de viure entel travail: Joint aussi, que je ne vouloye pas quil me fut Reproché de ne l'avoir seu tirer, (qui estoit à moy grand folie) je deliberay avec l'importunité du pere, Mere, & amis, de Copper le dit enfant par dessus l'os Pubis, d'au­tant que la Pierre ne voulut descendre bas, & fut Coppé sur le Penil, un peu a Costè & sur la Pierre. Car je leuoys icelle avec mes doigts, qui estoyèt au fondment, & d'autre Costé en la tenant subiette avec les mains d'un Serviteur qui comprimoit le petit ventre [Page 5]au dessus de la pierre, Dont elle f [...]t tirée hors par ce moyen, & puis apres le patient fut guary, (non obstant qu'il en fut bien malade) & la playe consolidée: Combien que je ne conseille a [...]omine d'ainsi faire. Ains plust­ost user du moyen par nous ino [...]nt [...] du quel nous venons de parler."

This is (in his own Words) all that he says about it: Which, for the Benefit of those that don't understand French, I shall translate into English, thus:

‘"He says, he had a Child about two Years old, who had a Stone in the Bladder as big as a Hen's Egg, brought to him to cut: He used all his Dexterity to force the Stone down to the Neck of the Bladder, but found it impossible to be done: The Child was in that Torture and Misery, that the Parents wished him rather dead, than he should live longer in so doleful a Condition. De Franco, on the other Hand, thinking it would tend to his Dishonour not to take away the Stone, at last re­solv'd to make Tryal, whether he could not bring it to the very Groin, which he did, by putting his Fingers into the Fun­dament, and raising up the Stone, he caus'd his Servant, on the other Side opposite to him, to press it down to the Place in­tended for Incision; which he made, took out the Stone, and, tho' the Child was [Page 6]very weak, recover'd him, and heal'd the Wound: But he advises others not to fol­low his Example; and, instead of it, re­commends the Operation which he calls his own Invention, and has describ'd, in the foregoing Part of the same Chapter."’

The next to him, that's said to have per­form'd it, is one Bonnet, of whom Mons. Tollet, in the 5th Edition of his Lithotomy, publish'd at Paris 1708, gives the following Account, Page 139.

‘" Feu M. Jonnot m'a dit autrefois que M. Bonnet Chirurgien, qui praetiquoit il ya tres-long-temps la Lithotomie dans l' Hôtel Dieu de Paris, l'avoit assuré d'en avoir taillé de cette faaeon. M. Petit, Maitre Chirurgien faaeon de cet Hospital mà dit l'avoir vu pratique sur une Petite fille par le même M. Bonnet."’

‘"Mr. Tollet says, that the late Mr. Jonnot (who was also a famous Lithotomist) told him formerly, that Mr. Bonnet, a Surgeon, who practis'd Lithotomy a considerable Time ago in the Hotel Dieu at Paris, assur'd him, ( viz. Mr. Jonnot) that he had cut after that Manner. Mr. Petit, Master-Sur­geon of that Hospital, also told our Au­thor, that he had seen it practised by the same Bonnet on a young Girl."’

Mons. Dionis, in the 2d Edition of his Course of Chirurgical Operations, publish'd at Paris 1714, Page 139, gives the following Account of the same Man, viz.

‘" On nous assure que Monsieur Bonnet a pratiqué sovent cette Operation à l'Hôtel Dieu de Paris avec une heureux succés, & que même Monsieur Petit luy a vû faire."’

‘"We are assur'd, that Mons. Bonnet, fre­quently and with good Success, perform'd this Operation at the Hotel Dieu in Paris; and that Mons. Petit has seen him perform it."’ This is all the Account that I have met with of this Bonnet.

After him, Dr. Groenevelt was the next that perform'd it, of which he gives the fol­lowing Account in the English Edition of his Lithotomy, publish'd at London in 1710.

‘"I once had a Patient in Long Lane, Moor­fields, upon whom I was oblig'd to per­form this High Operation; and very suc­cessfully extracted the Stone, by making Incision near the Groin, the Patient soon recovering; which shews, that Wounds in the fibrous Part of the Bladder are not always mortal."’

Those are the only Three that I have met with, that ever pretended to have cut above the Os Pubis, i. e. into the Belly.

Franco cut so first, because he had a Pa­tient that he could not cut his own Way, tho', at the same Time, he had the Cha­racter of one of the best Lithotomists of his Age. But tho' he succeeded, yet, it seems, he found such Difficulties in it, that he would never do't again, and charges us never to follow his Example; which one would have expected that he should have explain'd in his Account of it, the better to deter others from the like Practice.

Bonnet is said to have done it several Times with Success; yet he don't recommend it to others as a Rule of Practice, nor was ever imitated by any of his Contemporaries.

Groenevelt did it but once, and says, he was oblig'd to do it: I suppose, in some such­like Case as De Franco's; and though he also succeeded, yet, instead of recommending it, he only draws this Consequence from it, viz. That Wounds of the fibrous Part of the Bladder are not always mortal.

Franco cut on the Hair above the Pubis, a little on one Side; Groenevelt near the Groin: But not one of them tells us what lustruments they used, or which Way they used them; whether they made a cross, ob­lique, or longitudinal Incision; whether they made the Incision at once, or at several Times, or what Position they put their Pa­tient in; all which, and many more Cir­cumstances, ought to have been exactly de­scrib'd, before any one could be said to have [Page 9]follow'd their Method; from whence I may very safely infer, that it will be no easy matter to tell which Way any of them made their Operations, and yet it's commonly asserted with the greatest Assurance (not with any Design to raise De Franco's Reputation, but to lessen mine) that I made this Operation after De Franco's Method, though he has told but very little of his Story, and I have told none of mine.

Upon the Whole, I must say, that it's a Mi­racle to me, that after so much Success, either they, or those that saw them do it, did not ei­ther continue the Practice of it, or give us more substantial Reasons why they disapprov'd of it; so far from that, they have not given us one Instance of a Patient's dying after this Section.

This Operation is also recommended as a very probable Way by Roussecus, Dionis, &c. yet not one of them was ever so far perswa­ded of it as to make the Experiment, how­ever several of them have undertaken (which none that ever made the Operation thought fit to do) to describe the Method how it may be done, i. e. to teach others to perform what they can't do themselves; (which, in my Opinion is the greatest Absurdity in Nature;) but to what Purpose, he that makes the Ex­periment will see.

Having thus recited all the Instances that I have met with of the Stone in the Bladder, being extracted through the Belly, in the Words of the Authors, That every one may [Page 10]be a Judge of the Encouragement I had to undertake this Operation from what has been done this Way before.

I shall next give an Account of the Ob­jections made against the fore-mention'd Gen­tlemens Operations, by some of the most au­thentick Authors that have mention'd them.

First, Some say that the Urine from the Bladder, and the Discharge from the Wound, will flow into the Cavity of the Abdomen or Pelvis, where Corrupting, will occasion several grievous and incurable Symptoms, amongst whom is Dr. Drelincount, &c. who expresses himself thus:

‘" Operatio Franconiana ut inventa est sic exolevit, quia dum perfunderetur Vesicae fun­dum Urina Effluebat in Abdominis Cavum & Mortem inducit, i. e."’

‘"The Franconian Section, viz. the high Operation, died assoon as it was invented; because when the Fund of the Bladder is perforated, the Urine flows into the Cavity of the Belly and causes Death."’

Secondly, Others say that the Wound being made in the membranous Part of the Bladder, won't heal again, amongst whom is Bar­bett, &c. who has these Words:

‘" Periculosa interim & in se molesta Operatio est, & quod si Labia Vulneris in Vesia facti haud uniantur Musculis Abdominis, exulceratio vesicae sequitur, magis dolorifica minus cura­bilis ipso Calculo, quae etiam incommoda effe­cerunt quod minus Operationibus aliis haberi coeperit à practicis veris, i. e."’

‘"It's a dangerous and in it self a trouble­some Operation; and if the Lips of the Wound made in the Bladder don't unite to the Muscles of the Abdomen, an Ulcera­tion of the Bladder will follow, more pain­ful and less curable than the Stone it self, which Inconveniencies have made it less esteem'd than the other Operations by true Practitioners."’

Thirdly, Mons. Thevinin, a very eminent Surgeon, in his Book of Chirurgical Obser­vations, publish'd at Paris in the Year 1669, Pag. 68. gives this Account of it, viz.

‘" L'hault appareil qui a este premierement prati­qué par de Franco n'est point en usage à present, à Cause de l'incision qui'l oblige de faire au fonds & corps inferieur de la vessic qui apporte de grand accidens, i. e."’

‘"The high Operation, first practisd by de Franco, is no more in Use, because the In­cision being made in the Fund and Body of the Bladder causes great Accidents."’

Fourthly, Others say that the Guts will burst out at the Wound, &c.

Thomas Fienus, in the 70th Page of his Book, De praecipuis Artis Chirurgicae controversis, Edit. 1602. gives his Opinion of this high Operation, in these Words:

‘" Praeter hactenus usitatam Sectionem exorcus est, Francisus Rousettus, qui in Libro suo de Partu Caesario scribit, videri longe securio­rem & faciliorem sectionis rationem futuram, si Venter aut Abdomen a Latere sub umbilico aperiantur, & imposita per foramen manu vesicae corpus vulneretur & inde calculus exi­matur. Sed illa ratio non valet: vesicae enim vulnus lethale est, & non potest consolidari, & quamvis aliquando legatur consolidatum, est tamen rara avis, & temerarium nimis foret, & quia illam rationem nemo secutus est, de ea non agimus, i. e."’

‘"Besides the common Ways of Cutting, there's one Fr. Rousettus, who affirms in his Book of the Caesarian Birth, that the Operation would be safer and easier, if we cut through the Belly (a little below the Navel, and on one Side) and into the Bladder, and then extracted the Stone through the Wound. But that can't be, because Wounds of the Bladder are mor­tal, and cannot be consolidated; altho' we have some Histories of their being cur'd, [Page 13]it's a great Rarity, and therefore it's too rash an Undertaking; and because no Body practises it, I'll say no more on't."’

The Answer to all which (not to descend to Particulars) is the happy Success of my Operation.

The next Question that naturally follows, is, What could incite or encourage me to undertake this high Operation, which those that had done it, had such an indifferent Opi­nion of, which those eminent Authors (just quoted, and almost every one else that have mention'd it) exclaim'd so warmly against, and which, by the common Consent of Man­kind, was deem'd impracticable?

To which I answer: That it was, first, because I was fully perswaded that the great Danger, Tediousness, and frequent bad Con­sequences of the common Operations, were entirely owing to the Structure of the Parts concern'd, which the best Operator could not avoid, if the Stone was of any consi­derable Bigness, or of a rugged irregular Figure.

Secondly, Because I was as firmly per­swaded, that all the Objections made against the fore mention'd Gentlemens Operations, (so far as they concern mine) were very ill grounded; which is prov'd by the Success.

The Two Operations that are only in Use now amongst us are, First, That which Sur­geons call Cutting on the Staffe, i. e. When a furrow'd Probe is pass'd into the Bladder, upon which they afterwards Cut.

The other is call'd cutting on the Gripe, i. e. When they pass their Fingers into the Fundament, and press the Stone outwards, and then cut upon it.

In order to explain what I have just now asserted, viz. That the Danger, Tedious­ness, &c. of the common Operations, are entirely owing to the Structure of the Parts concern'd. I shall first describe the Parts concern'd in each, and then make such Con­clusions as naturally follow therefrom.

Cutting on the Staffe is most in Use, and therefore I shall begin with it.

Parts concern'd in Cutting on the Staffe, or Great Apparatus.

Parts Cut:

They cut first through the Skin, on one side of the Rapha of the Perinaeum.

2 dly, Through the Accelerator Muscle.

3 dly, Through the Bulb of the Urethra.

Parts that are dilated.

The Incision being made, opens a Passage into the membranous Part of the Uretha, at the upper-end of which is the Sphincter of the Bladder, through both which the Instru­ments [Page 15]must pass into the Bladder, and the Stone, tho' enlarg'd by the Thickness of the Forceps, must pass out.

They are both apt to be too much dilated by a large, and lacerated by a rugged Stone.

The membranous Urethra, is about Two Inches long, more or less, according to the Bigness of the Person.

It's about as big (in a middle-siz'd Man) as to admit of a Goose Quill.

It's much longer, and not so thick and strong, as the Urethra in Women, and conse­quently more liable to be injur'd.

The Sphincter is a few circular Fibres; which keep the Bladder shut, and so prevents the involuntary Discharge of the Urine.

The Genital Parts, which by the Nearness of their Situation are liable to be injur'd, next after the foremention'd, are:

First, The Vesiculae Seminales, i. e. the Re­servatories of the Seed: They are situate im­mediately behind the Sphincter, between the Bladder and Rectum, i. e. the straight Gut.

Secondly, Their Ducts; which pass from them, and open about the Middle of the membranous Part of the Urethra, by Two Orifices, which are cover'd by a sort of a Caruncle, call'd, Caput Gallinaginis, or Veru­montanum; which serves instead of Valves, to hinder the involuntary emission of the Seed.

Thirdly, The Prostatae; which are situate a Little below the Vesiculae Seminoles, between the membranous Urethra and straight Gut.

The Structure and Situation of the Parts being thus stated, it will not be difficult to deduce all die foremention'd Inconveniencies from them, viz.

First, The Danger of this Operation (to say no more) will appear from a Computati­on of the Number of those that do and do not escape after it; which is (in general) oc­casion'd by the Length and Streightness of the Passage before describ'd, Figure and Bigness of the Stones, Force requir'd to extract them, &c. Whence the foremention'd Parts, &c. are lacerated and contused to too great a Degree, and thence excessive Pain, Hemorrhagy, Loss of Strength, &c. too great to be master'd.

Secondly, Every one that has made, or seen any Number of these Operations perform'd, cannot but be sensible of the Tediousness of them (and consequently of the Pain the Pa­tient must needs suffer) which is owing to the Length and Streightness of the Passage (which cannot be alter'd, as is commonly suppos'd, by enlarging the External Orifice,) Num­ber, and Necessary Largeness of the Instru­ments used; Number, Bigness, and Figure of the Stones, &c.

Thirdly, The bad Consequences that fre­quently follow this Operation (in those that [Page 17]escape with Life) are, Incontinency of Urine, Impotency, Fistula's, &c. which every one must be satisfy'd of, that have seen any Number of them: In some of whom you'll observe [...]n Incontinency of Urine, in others Impotency, in others Fistula's, in others all of them; any one of which is very little better than the Stone itself.

Cause of the Incontinency of Urine.

It's caused when the Sphincter of the Blad­der is over-stretched by the Bigness, or lace­rated by the Asperitys of the Stone; because it can never afterwards do its Office as before; And so the Urine flows involuntarily Day and Night; which keeps them always wet, from whence none of the most agreeable Scents arise.

Cause of the Impotency.

It's occasion'd by the Laceration of the Ducts of the Vesiculae Seminales, or the Veru­montanum; and that by the Bigness or Aspe­ritys of the Stone, as before: So when the Wound heals, the Ducts, or Verumonta­num; are stopp'd by the Callous, so that the Seed can no more flow into the Urethra.

Cause of Fistula's.

These Parts are Membranous, Nervous, or Spermatick, as Authors call them, and, of Course, very unapt to heal when wounded, lacerated, or contused; which is also in­creas'd by the constant Passage of the Urine, Gravel, &c. thro' the Wound, and so they turn fistulous; and then all or a great Part of the Urine, which should pass thro' the Yard, passes thro' the Fistula left in the Wound; whence People are made nauseous to themselves and others.

The Great Hildanus, pag. 733, expresses the Danger of this Operation in these Words:

‘" Ingens ac magnus Calculus ut per Collum Vesicae extrabatur, propter ejus angustiam longum requirit tempus, interim aeger ingen­tibus affligitur Doloribus, Vesica, ipsiusque Fibrae dilacerantur, Sanguis copiosè profluit, vires dissolvuntur, maximoque cum Cruciatu aeger vel in ipsa Operatione aut paulò post extinguitur, i. e."’

‘"When a large Stone is extracted through the Neck of the Bladder, because of its Streightness, it takes up a long Time: In the mean Time, the Patient suffers intole­rable Pain, the Bladder and its Fibres are [Page 19]tore, there's a great Flux of Blood, Loss of Strength, and the Patient, by reason of the great Torture, dies, either in or soon after the Operation."’

The late Mr. Couper, in his Comment upon Bidloo, has the following Observations on the Accidents which happen from the Stru­cture of the Parts.

‘"This Part of the Urethra, viz. that be­tween the Prostatae and the Bulb, is liable to be wounded, and sometimes perforated, by too hastily introducing the Conductor into the Bladder, after an Incision is made in the Perinaeum in Cutting for the Stone; whereby the Operator afterwards thrusts his Forceps between the Bladder and Re­ctum."’

‘"This Inadvertency, I'm persuaded, is very often practised by the Pretenders to Lithotomy, and frequently proves fatal to the Patient: One would think it hardly possible, that a Man in his Senses, and but tolerably acquainted with Anatomy, could commit such Errors; yet, of this I have met with more than one Instance, when being called to dissect the Deceased, in whom such Operators have been so un­fortunate as to leave the Stone still in the Bladder."’

So much to shew the unavoidable Danger, &c. of Cutting on the Staffe.

The other Operation in use is Cutting on the Gripe.

Parts cut.

They cut (farther off of the Rapha of the Perinaeum than in the foregoing Operation) 1. Through the Skin: 2. The Fat: 3. Part of the Erector Penis: 4. Some confiderable Blood-Vessels: 5. A Part of the Levator Ani: 6. Into the Body of the Bladder above the Sphincter.

This Operation can't always be practis'd, because our Fingers are not long enough to bring down and keep the Stone fast against the Perinaeum in grown People. Though, when it can be done,

The Inconveniencies of it are,

  • 1. When the Stone is rough, it's trouble­some, painful, and tedious, to make the In­cision on it.
  • 2. The Arteries, which are cut, are often very large.
  • 3. When the Stone is rough, it pricks, and contuses the Bladder in several Places, by being pressed hard against the Perinaeum; whence several dangerous and deadly Symp­toms ensue.
  • [Page 21]4. The Wound in the Bladder being de­pending, is hinder'd from aglutinating, by the Gravel and Urine passing thro' it, &c.

From all which, I think 'tis evident, that the rare Success of these Operations, even in the best of Hands, (not to mention the Havock that is often made by Pretenders) is entirely owing to the Structure of the Parts concern'd; which is what I undertook to prove.

Advantages of this new Operation.

Whereas, in the other Operations, the Danger, &c. are owing to the Structure of the Parts; in my Operation, by reason of the Structure of the Parts, they are success­fully prevented. E. G.

1. There can be no Impotency caused by it, because there's none of the Genital Parts can be injur'd in doing it.

2. There can be no Incontinency of Urine caus'd by it, because the Sphincter of the Bladder cannot be hurt in making it.

3. There can be no Fistula after it, if pro­per Care is taken of the Wound.

4. There can be no such Force requir'd to extract the Stone, as will contuse and lace­rate the Parts, which, in the other Opera­tions, are the Cause of Symptoms too hard to be govern'd) because the Wound may be [Page 22]made as large as you please, which can't be done in them.

5. There can't be any Flux of Blood, because there's no Occasion to cut any of the great Vessels, &c. Thus the Defects of the others are supply'd by this.

My Patient was between sixteen and se­venteen Years of Age, and was cut two Days before last Christmas, and in a Month's Time the Wound was perfectly cicatriz'd, i.e. healed.

The Operation was over in one Minute, and I believe will never be above two.

He now performs all his natural Faculties as well as he had never been troubled with the Stone.

There were two Physicians, two Surgeons, and an Apothecary, present at the Opera­tion: But to save them the Trouble of an­swering every little Prig's impertinent Que­stions, I don't think it's proper to mention them.

The Stone was of the Bigness and Figure express'd in the Plate following.

The Natural Figure & Bigness of y e stone

Some say that I have robb'd the Dead of their Right, and endeavour'd to impose on the Living, by putting my own Name to another Man's Work, and pretending that it's a new Operation, though, at the same Time, it was practis'd by its first Inventor, De Franco, above 150 Years ago.

De Franco (whose Memory I reverence, because he was certainly an excellent Sur­geon, and one of the best Lithotomists in his Time) is so far from valuing himself upon the High Operation, which he was once forc'd to make, that he owns himself to be very much to blame for doing of it; and desires no Man afterwards to follow his Example; and in the Room of that, in the preceding Part of that very same Chapter, recom­mends another which is made on the Peri­naeum, which he assumes, and, with a great deal of Pleasure, calls his own Invention.

Hildanus is also of the same Opinion, and expresses himself thus, Pag. 730.

‘" De quarto operandi modo, in Lithotomia usitato, qui merito Lithotomia Franconiana appellari potest."’

And so he goes on to describe and re­commend that Operation, which De Franco owns in the 33d Chapter of his Book, to be his proper Invention: But it's not the High, but an Operation in the Perinaeum, that's as­sum'd by the one, and commended by the other.

In Page 732, he has these Words:

‘"Franciscus Rousettus Lib. de partu Caesa­rio concludere voluit, semper calculum eo in [Page 25]Loco exsecandum esse, illudque minori cum pe­riculo fieri posse. Lithotomiam proinde illam Franconianam vocat, cum tamen D. Franc. eam minimè ad Imitationem praescripserit, sed expressè in Libro suo, se stolide egisse fateatur, adeoque unumquemque, ne ipsum hac in parte imitetur, sed precedentem operandi modum amplectatur, Hortetur."’

‘" Franciscus Rousettus, in his Book on the Caesarian Birth, asserts, that we ought al­ways to cut for the Stone through the lower Part of the Belly, because it can be done with a great deal less Danger; and then calls it De Franco's Method, notwith­standing De Franco never prescrib'd it as a Rule; so far from which, he confesses in his own Book, that he acted foolishly in doing it; and therefore advises us never to imitate him in it, but in the Operation just before describ'd."’

He concludes his Story thus:

‘" Cum dicto igitur D. Franco, fideli atque industrio cuivis Chirurgo periculosae hujus Lithotomiae Administrationem iterum atque iterum dissuadeo."’

‘"Therefore, with the foremention'd De Franco, I again and again dissuade every faithful and industrious Surgeon from per­forming this dangerous Operation."’

From all which I conclude, that instead of being an Honour to De Franco, to have had his Name put to it, it would have been a real Injury to the Memory of the Dead, to have made him the Author of an Operation, that he blam'd himself for doing when alive.

Nay, I'm so far from having an Opinion of De Franco's Operation, as he has describ'd it, that I think it's fully as inconsistent and impracticable as Talicotius's Project of re­storing lost Noses.

All the Analogy between his and mine, is, that they are both made in the Belly. But his was made in one Place of the Belly, and mine in another: His, with his own Instruments, (which he has not men­tion'd) mine with mine: His were used af­ter one Manner, mine after another: And those, I think, are the most material Diffe­rences betwixt any two Operations, viz. The Variation of the Place upon which the Ope­ration is made, of the Number, Figure, and Size of the Instruments, and of the Method of using them.

The two foremention'd Operations, call'd, Cutting on the Staffe, and Cutting on the Gripe, are both made on the Perinaeum: The Design of both is the same, viz. To extract [Page 27]the Stone out of the Bladder; yet no Man ever was so absurd as to call them both the same Operations, for the Reasons before­mention'd.

The late famous Mr. Rau, Professor of Physick and Surgery at Leyden, and the fore­mention'd De Franco, and several others, as Celsus, Guido, Marianus, &c. had each a par­ticular Method of Cutting on the Perinaeum, to which every one gave his own Name, and why should not I be allow'd the same Liberty.

But supposing that my Operation was, in every Tittle, the same as De Franco's; yet, if it's found to be a safer and easier Way of relieving the Miserable, it's nevertheless new; for that Operation was as much dead, before mine, and thought as much im­practicable, (which the general Opinion of the Town on this Occasion abundantly proves) as it was 150 Years before De Franco was born.

I readily grant, that one Operation, tho' successfully perform'd, is not enough to sa­tisfy the Publick that it's the safest Method; but it's enough to me, who, before the Ope­ration, thought myself very sure of Success, else I had never attempted it. But now I have perform'd it, and seen the whole Pro­cess of the Cure, I'm in no manner of Pain [Page 28]about the future Success of if; nay, I dare venture to prophecy, that not one in ten will die, nor one in fifty want a perfect Cure, that do after the common Methods; and there fore do (what never any did before) recom­mend it as the most easy safe, and speedy Method of extracting the Stone, (exclusive of all others) in Males, and when the Stone is large, in Females.

I have had a great many vile, malicious and salfe Reflections cast upon me, on this Occasion, by a Set of Scioli, who (because they never did anything out of the common Road themselves) envy every Man else that does.

The Imputation of Novelty (says the great Mr. Lock) is a terrible Charge among those who judge of Mens Heads, as they do of their Perukes, by the Fashion, and can allow none to be right but the receiv'd Doctrines. Truth scarce ever carry'd it by Vote any where at its first Appearance: New Opi­nions are always suspected, and usually op­pos'd, without any other Reason, but be­cause they are not already common: But Truth, like Gold, is not the less so, for be­ing newly brought out of the Mine.

Magna est Veritas, & prevalebit.
FINIS.

INDEX.

  • PLACE where this new Operation is made Page 3
  • An Account of three Surgeons that have made the High Operation P.4
  • The Opinions of some of the most eminent Authors about it P. 10
  • Remarks on the two Operations now in Use, viz. Cutting on the Staffe, and Cutting on the Gripe; whereby their Inconveniencies are explain'd P. 14
  • The Advantages of the New Way explain'd P. 21
  • The common Objection, viz. That this is not mine but De Franco's Operation, fully answer'd, &c. &c. P. 23

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