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stones; Leroy d'Etiolles developed his lithoprione, which trapped a stone. Also in 1822, Amussat showed his brise-pierre, which employed a rotary bur to fragment the stone. Both instruments were inadequate. A year later Civiale had abandoned his attempts to dissolve bladder stones and found his lithontripteur to be sufficient in dealing with bladder stones. This instrument, which could be inserted into the bladder, contained three prongs to grasp a stone in a straight shaft and a central drill driven by a bow. The instrument could grasp and re-grasp the stone and drill holes from different angles until the stone was fragmented and the pieces could be extracted with urination.

After some dispute, credit for the development of the first instrument to break a stone in the bladder of a living patient was given to Civiale. He received an award from the French Academy of Sciences of 6,000 francs in 1826 and the 10,000 franc Montyon Prize in 1887. Opponents of his instrument were labeled by Civiale as "butchers without the necessary delicate touch" who therefore insisted on using the old-fashioned perineal lithotomy. Civiale's instrument was tried in

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