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March 2, 1918


Author Affiliations

Hoi How, Hainan, China

JAMA. 1918;70(9):604. doi:10.1001/jama.1918.26010090001011

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Oct. 30, 1917, a man aged 31, entered the hospital complaining of great pain on urination, with pain over the bladder. The patient had been in this condition for over ten years, gradually getting worse. When he came to the hospital, he could not stand erect on account of the pain.

The man was emaciated, and his face and body were covered with pit marks of old smallpox. A sound introduced into the urethra met at the neck of the bladder a solid, immovable body. This could be palpated 2 inches above the pubes. The urine showed an intense cystitis. An incision was made above the pubes almost to the urbilicus and the bladder, which was distended with boric acid solution and opened. A large irregular stone was disclosed which was found to be impacted. Efforts to dislodge it proved fruitless, and finally a hammer and chisel were used to

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