In such cases there would be little pain, and premeditation would not be brought into play in the same degree as in the case of M.Clever de Maldigny, a surgeon in the Royal Guards of France, who successfully performed a lithotomy on himself before a mirror.

He says that after the operation was completed the urine flowed in abundance; he dressed the wound with lint dipped in an emollient solution, and, being perfectly relieved from pain, fell into a sound sleep.

On the following day, M.Maldigny says, he was as tranquil and cheerful as if he had never been a sufferer.

A Dutch blacksmith and a German cooper each performed lithotomy on themselves for the intense pain caused by a stone in the bladder.

Tulpius, Walther, and the Ephemerides each report an instance of self-performed cystotomy.
The following case is probably the only instance in which the patient, suffering from vesical calculus, tried to crush and break the stone himself.