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In 1836, Mercier first vigorously called attention to the occasional occurrence of obstructions at the prostatic orifice in cases other than prostatic hypertrophy, and gave them the name ofvalvules du col de la vessie. He described quite accurately the elevation of the median portion of the prostate in the form of a bar, which he said in some cases was due to muscular hypertrophy, and in others to a glandular enlargement in this region. Mercier devised an instrument somewhat like a lithotrite by means of which he operated in a number of cases with fair success, but his operation was never adopted and soon fell into disuse. Later French writers, particularly those of the Guyon school, departing from Mercier's teachings, have attributed the condition to lack of bladder tonicity, and the termprostatisme sans prostatehas been quite generally used to describe this condition, which they believed to be

During the last ten years, lithotomy has been written on extensively. Does this indicate that, in the advancement of surgical technic, lithotomy has become the operation of choice, or that litholapaxy is too dangerous a procedure? The advancement in prostatic surgery no doubt eliminates the stone cases that are complicated with a prostatic hypertrophy as these are today handled at the time of prostatectomy. We have always been of the opinion that in an uncomplicated case of vesical calculus lithotrity or litholapaxy is the operation of choice. OBJECTIONS TO THE PRESENT METHOD Objections to the present method may be divided into two groups: (1) when the plain lithotrite is used, and (2) when the cystoscopic lithotrite is employed. Under Group 1, the objections are that: ( a ) The operation is performed blindly. Everything depends on the sense of touch and good fortune. Neither the instrument nor the calculus is under the

One of the difficulties in removing stones from the urinary bladder with the ordinary lithotrite is that the process is not under sufficient visual control, and it is not easy to get out all of the fragments even after they have been crushed. Residual fragments become the nuclei for further stone formation. Lithotrites which embody a cystoscopic telescope are now available. Some of these instruments are of so large a caliber as to have a limited field for use. For crushing stones, the Bigelow lithotrite is still a very good instrument, and can be found in many hospitals. Most of the evacuators heretofore in use have been more or less cumbersome. The work has to be done blindly, and considerable irrigation is sometimes necessary in order to remove all fragments. Apparently no one method is applicable in all cases. The device here presented is intended to simplify the complete removal