The subsequent history of suprapubic lithotomy shows that Franco was laboring under an exaggerated idea of the dangers attending this operation. The comments of Pascal Baseilhac—a nephew of "Brother Cosmas" (the famous French lithotomist of the early part of the eighteenth century) and himself a skilled lithotomist—are worthy of being repeated here. He says (p. 318 of his "Traité sur la lithotomie," Paris, 1804): "Franco based his unwillingness to recommend the operation of suprapubic lithotomy on the belief which was then widely prevalent, and which still persists even in our time (middle of the eighteenth century), that the making of an incision into the main body of the urinary bladder is sure to prove fatal, a belief which experience and observation have now shown to be unwarranted."
The Franconian operation, the great value of which was not sufficiently appreciated by its inventor nor by contemporary surgeons, was revived in 1719 by an Englishman, John Douglas, the distinguished surgeon of Westminster Hospital, London, and the brother of James Douglas—the anatomist who in 1730 described so minutely the relations of the peritonaeum to the bladder (Douglas' cul-de-sac).
In the case the history of which has just been narrated, the circumstances attending the invention of the operation known to-day as suprapubic cystotomy[1] or "suprapubic lithotomy," were certainly of such an unfavorable character as to call for the display of an unusual degree of courage, wisdom, patience and manual skill on the part of the surgeon in charge; and it was through a careful consideration of these facts that Edouard Nicaise was led to award such high praise to Franco for the work which he had done. Scarcely less remarkable is the talent which the latter
- [Footnote: *mention (in medical literature) of these instruments occurs in Chapter XV.
of the treatise of Guainerio, Professor of Medicine at the University of Pavia. This work, which was first published in 1439, bears the title: "Practica Antonii Guainerii," and a later edition was issued at Venice in 1508. Speaking of a case of stone in the bladder, Guainerius says: "And if the urine does not flow from the bladder . . . introduce a slender flexible rod of tin or silver into the urethra."]
- ↑ Franco calls it the "high operation" or "hypogastric lithotomy."
