The Body: A Guide for Occupants

by Bill Bryson

Probably history’s most famous lithotomy, or stone removal, was that experienced by the diarist Samuel Pepys in 1658, when he was twenty-five years old.18 This was two years before Pepys started his diary, so we don’t have a first-hand account of the experience, but he mentioned it frequently and vividly thereafter (including in the diary’s very first entry when he finally started it), and lived in loquacious dread of ever having to undergo anything like it again. It’s not hard to see why. Pepys’s stone was the size of a tennis ball (albeit a seventeenth-century tennis ball, which is slightly smaller than a modern tennis ball, though the distinction could fairly be called academic to anyone carrying one). While four men held Pepys down, the surgeon, Thomas Hollyer, inserted an instrument called an itinerarium up his penis and into the bladder to fix the stone in place. Then he took a scalpel and quickly and deftly – but excruciatingly – cut a three-inch-long incision through the perineum (the area between the scrotum and anus). Peeling back the opening, he gently cut into the exposed and quivering bladder, thrust a pair of duck-billed forceps through the opening, captured the stone and extracted it. The entire procedure from beginning to end took just fifty seconds, but left Pepys bedridden for weeks and traumatized for life.fn1