Page:The growth of medicine from the earliest times to about 1800.djvu/543

 character that he invented the very important surgical procedure known in France as the "Franconian operation for stone in the bladder" (hypogastric cystotomy, suprapubic lithotomy). Here is the account which he gives of the circumstances under which he was led to devise this method of removing a stone from the bladder:—

I will mention here an experience which I had on one occasion when I tried to remove a calculus from the bladder of a boy about ten years of age. The stone was about as large as a hen's egg and resisted all my efforts to extract it by way of the incision made in the perinaeum. Being in a quandary as to how I should proceed next, and the parents and friends being greatly demoralized by the suffering to which I was unavoidably subjecting their child,—they maintained, I should add, that they would rather have him die than be subjected to such awful suffering;—and being influenced also by the thought that I could not afford to have it charged against me that I was not able to extract the calculus, I deliberately decided that I would make an opening above the pubic bone, and would remove the stone in this manner. Accordingly I incised the skin above the pubes, a little to one side of the base of the penis, and carried the knife through the soft tissues down to the calculus, which I had simultaneously pushed upward by pressing the fingers of my left hand against the perinaeum, while at the same time my assistant made counter-pressure against the stone by firmly compressing the abdominal wall above the object. This method of extraction proved successful.

In due time the wounds healed firmly and the patient was relieved of his trouble, but only after a long and most serious illness.

Franco does not appear to have performed the suprapubic operation for the extraction of a cystic calculus more than once (the case just narrated), and he carefully refrains from recommending it to other physicians. Most surgical authors, says Edouard Nicaise, blame Franco very strongly for not having dared to recommend his suprapubic operation. "But I do not agree with this judgment; Franco should rather be praised for his prudence in not immediately announcing to the world his invention of an important surgical operation."