A SURGICAL INSTRUMENT FOR DESTROYING THE STONE IN THE BLADDER WITHOUT CUTTING, WHICH HE DENOMINATES LITHONTRIPTOR'
Year: 1825

page_text: TO ALL TO WHOM THESE PRESENTS SHALL COME, I, ISAIAH
LUKENS, late of Philadelphia, but now of Adam Street, Adelphi, in the County
of Middlesex, Machinist, send greeting.
WHEREAS His present most Excellent Majesty King George the Fourth,
by His Letters Patent under the Great Seal of Great Britain, bearing date
at Westminster, the Fifteenth day of September, in the sixth year of His
reign, did, for Himself, His heirs and successors, give and grant unto me, the
said Isaiah Lukens, His especial licence that I, the said Isaiah Lukens, my
exors, admiors, and assigns, or such others as I, the said Isaiah Lukens, my
exors, adñiors, or assigns, should at any time agree with, and no others, from
time to time and at all times during the term of years therein expressed,
should and lawfully might make, use, exercise, and vend, within England,
Wales, and the Town of Berwick-upon-Tweed, my Invention of "A SURGICAL
INSTRUMENT FOR DESTROYING THE STONE IN THE BLADDER WITHOUT CUTTING, WHICH
HE DENOMINATES LITHONTRIPTOR';" in which said Letters Patent is contained
a proviso obliging me, the said Isaiah Lukens, by an instrument in writing
under my
hand and seal, particularly to describe and ascertain the nature of
my said Invention, and in what manner the same is to be performed, and to
cause the same to be inrolled in His Majesty's High Court of Chancery
within six calendar months next and immediately after the date of the said
recited Letters Patent, as in and by the same, reference being thereunto had,
will more fully and at large appear.

page_text: NOW KNOW YE, that in compliance with the said proviso, I, the said
Isaiah Lukens, do hereby declaro the nature of my said Invention by the
following description thereof, reference being had to the Drawing and figures
marked thereon (that is to say):-
Be it known that I have made a new and useful improvement in an instru-
ment called the "Lithontriptor," lately introduced in Paris by Mr Civiale, M.D.,
for the purpose of destroying the stono in the bladder without the operation of
lithotomy. The instrument of Mr Civiale consists of a straight cylindrical
cathetor, sound, or tube of silver or other metal, through which is introduced a
second tube, formed of steel, terminated by three curved elastic branches or
prongs, which remain closed so long as they continue in the exterior tube, but
when pushed out open by virtue of their clasticity, and form a kind of cage,
in which the stone is made to enter, and which is then shut upon it by drawing
the exterior tube backwards. When the stone is thus engaged, drills, files, &c.,
are introduced through the tubes, and by their means the stone is destroyed.
The improvement which I claim to have made consists in adapting to the
clastic branches or prongs, which may be either three, four, or more in
number, fine springs of steel or other metal, which are fastened at one end to
one of the branches or prongs by a hinge or otherwise, and pass across to an
opposite branch or prong through small eyes or holes, then pass along the
interior of the tube in seperate branches or united, until it reaches the handle
of the instrument. It then passes out of the tube through a small transverse
hole or holes, and is attached to a collar which slides betwixt the handle and
end of the instrument. When this collar is drawn back the elastic branches
or prongs may be pressed together, and the whole readily introduced through
the catheter or conductor into the bladder; when there, the branches or
prongs expand, and the springs are pushed forward by the operator, so that
a kind of basket or net work is formed, into which the stone or calculi is
introduced. The springs are then drawn tight upon it, and fastened by a
screw at the sliding collar or otherwise. The instruments intended to destroy
the stone are then introduced through the inner tube alongside of the springs,
which, being curved, occupies but a small portion of the cavity of the tube.
In another arrangement of the springs they are attached at one end to a small
ring by a hinge or otherwise, corresponding in number to the branches or
prongs of the basket forceps, the extremity of which each prong is provided
with a small eye. The springs pass through those eyes, and into the interior
of the tube, and then is managed as above described in the first arrangement
of the springs. This instrument may be curved, should it be wanted for
withdrawing small calculi through the mithra.

page_text: The duck-bill forceps:-This instrument is intended for the purpose of re-
moving fragments of the calculi or gravel, by passing it through the conductor.
It consists of two tubes of steel or other metal, one inside the other. The
exterior one is furnished with two elastic branches or bills, standing open at their
extremity, and somewhat smaller and contracted at their base, which admits of
a small ring of collar to embrace the bills, leaving them standing open at their
extremity. The inner tube is also furnished with two slender branches, which
are attached to the inside of the ring or collar; by pushing the inner tube for-
ward the collar is made to slide along the bills, and close them; and the
reverse motion to, open them. The inner tube is somewhat longer than the
exterior one, and is furnished with a ring for the thumb or finger of the
operator. Small drills or other instruments may be introduced through
the tubes to reduce the fragments should they be found too large to with-
Fig. 1. A, B, the conductor, three and a half lines in diameter and ten
inches long, slightly funnel-shaped at H, for the purpose of more readily intro-
ducing the basket forceps.
Fig. 2. C, D, the basket forceps, eighteen inches long, and of a size to pass
into the conductor without much friction, and is provided with four elastic
prongs, differing a little in their length; Y, Y, the extremity of two of tho
longest prongs, to which is attached by hinges two fine springs of steel, which
cross each other at L, then pass through small eyes at J, J, and then pass into
the interior of the tube and is united, then pass out through a small transverse
hole at a, and is attached to the sliding collar T; P is a screw for fastening
it; U, the handle of the basket forceps; W, a collar with a screw, for the
purpose of keeping the conductor in its place and giving support to the
prongs.
Fig. 3rd represents part of the basket forceps and conductor as if broken off,
holding a calculi. B, the conductor; C, the forceps tube; D, the spring, which
is slit at one end, and passes through small eyes at the extremity of two of the
prongs, and cross each other at L, and are attached by small hinges at N, N.
Fig. 4. D represents part of the basket forceps; P, a small ring, to which
is attached by hinges four small springs; D, D, D, D, small eyes, through
which the springs pass,. and then enter the interior of the tube, the ends of
which are seen at F, and then is managed the same as in Fig. 2nd, by passing
them out of the tube through a small transverse hole or holes, and is attached
to the sliding collar I.

page_text: Fig. 5. I, K, the duck-bill forceps. 0, 0, the bills; A, the inner tube;
N, a small collar, attached to the branches of the inner tube, for the purpose
of closing the bills; M, a ring, for the thumb or finger of the operator.
Fig. 6. E, F, a drill, with a square cutting end; L, a small cone, to
prevent the escape of urine; r, a collar, with a fastening screw to regulate
the drilling, and to prevent injury being done to the patient.
Fig. 7. G, H, a rimmer; V, an arm, moving on a pivot; S, a cone to
prevent the cscape of urine; T, a collar and fastening screw to regulate the
movement.
Fig. 8, a drill stock, enclosed in a cylinder so as to prevent the cord II
from being disengaged. L, a square hole, for the reception of the drill;
G, the breastplate or base.
In witness whereof, I, the said Isaiah Lukens, have hercunto set my
hand and seal, this Fourteenth day of March, in the year of our Lord