(From a stone, and a plani). A lithophyte, keratophyton coral; a species of plant of a horny substance, seeming to be of a middle nature betwixt wood and stone.

Lithophyton nigrum. See Corallium nigrum. Lithospermum, (from and semen; from the hardness of its seed). Milium solis, AEgonychon, aetonychum, gromwell, graymill, li-thospermum officinale Lin. Sp. Pl. 189, is a rough plant, with stiff branched stalks, oblong acuminated leaves, set alternately without pedicles, and whitish, monopetalous flowers, scarcely longer than the cup, followed by roundish hard seeds. It is perennial, grows wild in fields, and flowers in May and June. The seeds are diuretic; but rarely used. See Lewis's Materia Medica. It is also a name for the lacryma Jobi. LithotomIA, (from a stone, and to cut). Cystotomia. Lithotomy, or cutting for the stone.

This operation was performed in the time of Hippocrates, but confined to one family; and, in the oath to be taken by practitioners, this operation is forbidden, apparently, because those to whom so delicate an incision was familiar would perform it more dexterously. The method employed we shall soon describe as that with the "lesser apparatus." This method was improved in the sixteenth century, by Joannes de Ro-manis, whose operation was styled that with the

"greater," as it was a more complicated" apparatus." It is described by Marianus Sanctus, who wrote so clear and comprehensive a description of the operation, with the parts concerned, that it includes every method of opening the bladder, and very plainly hints at the improved lateral method. The high operation was first proposed by Franco, a French surgeon, in the same century. The various inconveniences which attended each rendered the attempt uncommon, till a French priest, Frere Jacques, probably catching the hint from Marianus, attempted the lateral method; which, though unskilled in operations, and indifferently provided with instruments, he executed with a success which excited the applause of the world, the indignation, and, at last the emulation, of the faculty. Various improvements have been since made, which we shall notice in their place.

We have already spoken of the symptoms of Calculus, vide in verbo, nor need we add to them, since the ultimate decision depends on the sound. This is, in fact,, a part of the operation.

When a stone is suspected to be lodged in the bladder, and a fuller examination is necessary, an instrument called a sound is introduced into the bladder, if possible, to feel the stone. For this purpose, Mr. Sharp directs"the patient to be laid on an horizontal table, with his thighs elevated, and a little extended: the sound, previously warmed and oiled, is then passed, with the concave part towards the operator, until it meets with some resistance in the peri-nuaem, a little above the anus: it must then be turned without much force, pushed gently on into the bladder; and if it meets with an obstruction at the neck, its extremity is raised upwards, by inclining its handle. If it do not then slip in, it should be withdrawn a quarter of an inch, the fore finger introduced into the rectum, and the point lifted up, which will facilitate its admission." See Catherismus.

When the sound enters the bladder, it must be moved round in every direction. It sometimes at once strikes against the stone, and by no artifice is the stone again found. Sometimes none meets the instrument. As its weight may drag the bladder down on the rectum, the finger, should be introduced into the gut, and that part of the bladder raised, or the body should be moved into different positions. We have remarked, that in discovering a stone we are more often indebted to chance than to skill; but, if once found by an experienced surgeon, the operation may be performed. We say by an experienced surgeon, since it is said that pieces of sand may strike against the catheter, and give the sensation of a stone. This, however, will not mislead a person who has once felt it. The sensation imparted by the instrument is not decisive of the size of the stone; and a small stone is often as readily found as a large one: but if inclosed in a sac, or if adhering to the bladder, the wrinkles of the inner coat defend it, and the sound will not detect it. If the patient uses some exercise before the search, it may detach the stone from slight adhesions.

After the operation, children relapse more frequently than adults; and adults run greater hazards in the operation than children.

The method employed from the first attempts to extract the stone has been called the Celsian, sometimes the Guidonian, operation, cutting upon the gripe, or with the lesser apparatus. This operation will appear to be an obvious one; but the term apparatus is improper, since it only requires a common scalpel, and occasionally a hook. The child, for it is confined to children, though Paulus of AEgina observes, that he has practised it in a more adult age, is held in an oblique position, and the finger, introduced into the rectum, is employed in pressing the stone forward against the perinaeum, and confining it. The operator then cuts on it, and extracts it, assisting the extraction, if large, with the hook. Heister tell us, that he continued to employ this mode of operating in young subjects. The operation was too simple, perhaps, for modern refinement, but it had also some inconveniences. It was not easy to find the stone from the rectum, or to confine it against the perinaeum, for the time necessary to extract it. The operation also was confined to young subjects, where the parts were thin, and the pressure of the stone against the very sensible bladder was often followed by mortification.