the difficulty that was
experienced in expelling the pieces of stone, the operation was seldom
employed by surgeons. The improvements in these methods at the hands of
Bigelow and Sir Henry Thompson, with those that have been made by our
specialists, have resulted in our being able to present to sufferers
with this disease, a means of cure which is, we are assured, the most
successful known to modern medical science.

There have been so far in the history of the treatment of this malady by
the new method of cure, one hundred and twenty-odd cases operated upon
at the hands of prominent surgeons, all of which were with less perfect
methods than that of our specialists, and there were but four deaths in
this large number. By the advantages which are the result of further
improvements by our specialists, we can assure you that this mortality
is even less in our hands; in fact, approaches, as near as possible, to
a perfect method of cure.

We think that in a moderately healthy subject, one in which the kidneys
are not badly diseased as the result of irritation from the calculus,
the operation is almost absolutely safe. The method consists in the
crushing of the stone, and its removal from the bladder by means of
small silver catheters attached to an apparatus which gently and
perfectly removes, by suction, all the pieces which are thrown to the
bottom of the bladder. This operation has now been performed in our
institution in a very large number of cases with uniform success, and
the cures have been effected in from six to eight weeks without a single
unpleasant symptom arising during their progress. By this method it is
not necessary to remove the entire calculus at one operation, if it is a
large one. By the old cutting operation this was required, as the
bleeding was great, and what was to be done had to be done immediately,
or the patient would die from the _hemorrhage_. With the new method a
part of the large calculus, or when several exist, one or two of them,
may be removed at a time, after which the patient can rest and gain
strength for the second; or, if necessary, for the third operation.

The largest stone removed by us in this way was one weighing between
seven and eight hundred grains, for which three operations were
required. It is necessarily performed under a mild anaesthetic, which
prevents suffering and secures the perfect relaxation of the patient. In
the case in which this large amount of stone was rem