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."[1]
- ↑ In the absence of a more fitting place in which to speak of the employment of urethral bougies, it seems permissible to state here that the first*
