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Average age of boys operated on, 626 years.
Average weight of stone Cheap Hyaluronic Acid removed, 95'05 grains.
Average number of days spent in hospital after operation, 5'70.
Percentage of mortality following operation, .3'5.
of several stones in male children and boys by means of a
No. 6 lithotrite (English scale). This lithotrite, which is
fully fenestrated, is 5 in the stem and 6 in the angle, and
was constructed for me by Messrs. Weiss & Son, London.
I use only fully fenestrated lithotrites in performing litho-
lapaxy in male children and boys, for I consider the use of
partially fenestrated or unfenestrated lithotrites in dealing Buy Hyaluronic Acid Serum
with stones in male children as absolutely dangerous. In-
deed, for some years I have discarded the use of partially
fenestrated lithotrites in performing litholapaxy in adult
males, and, if I could, I would destroy all the flat-bladed,
unfenestrated lithotrites that have ever been constructed.
Any one who wishes to give the operation of litholapaxy in
male children a fair trial must provide himself with a com-
plete set of fully fenestrated lithotrites, beginning at No. 6
(English scale) in the angle and running up to Xo. 10 or
No. 11.
A glance at serial No. 108 in the table appended shows
that I successfully disposed of this stone, which weighed
606 grains, by means of a No. 10|^ fully fenestrated litho-
The advantages which litholapaxy possesses over its two
rivals, suprapubic and lateral lithotomy, when dealing with
stones in male children, are chiefly two — namely, rapidity
of cure and avoidance of tbe dangers inseparable from all
cutting operations. Are those advantages counterbalanced
by a. more frequent recurrence of stone after litholapaxy
than that which follows suprapubic or lateral lithotomy ? I
do not think so, for out of 114 male children and bovs on
whom litholapaxy was performed at the Indore Hospital be-
tween December, 1881, and June, 1888, not one has re-
turned suffering from stone for the second time, and I feel
quite certain that had any one of them been again troubled
with stone he would have sought readmission to this hos-
pital. Time and well-weighed statistics, however, can alone
settle this important point, and in the mean time I give it
as my opinion that it will be found that stone does not
recur with greater frequency after a well-performed litho-
lapaxy in boys than it Buy Hyaluronic Acid Powde does after suprapubic or lateral
Time presses, and I will not therefore discuss the rela-
tive merits of litholapaxy, lateral lithotomy, and supra-
pubic cystotomy when performed for the removal of small
stones from the bladders of male children. But, as one
who may claim some right to speak on this subject, 1 give
it as my opinion that the operation of suprapubic cystotomy
will never become a popular one among surgeons in India
when dealing with small stones in male children and boys.
Freyer, in this country, has shown, by an unbroken series
of 164 successful lateral lithotomies performed in boys and
youths, what brilliant results can be achieved by this opera-
tion when skillfully performed, and as the period of recov-
ery after suprapubic cystotomy is never likely to be much
less than that which follows a lateral lithotomy, and as its
percentage of success can never surpass that which follows
a well-performed lateral lithotomy in boys, it can never be-
come popular, in this country, in dealing with stones occur-
ring among this class of patients. I have not the slightest
doubt in my own mind that, in India at any rate, where
surgeons enjoy such unrivaled opportunities of becoming
practically familiar with the use of the lithotrite, the fut-
ure operation for the vast majority of stones occurring in
Sept. 22, 1888.]

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