Some lithotrites, such as Heurteloup’s form, called for the use of a percussion hammer to deliver a sharp blow to the proximal end of the instrument once the stone was properly secured in its jaws.  Hammers intended for this purpose were manufactured from steel or bronze as opposed to the lead hammers used for trepanation and orthopedic surgery that function on a ‘dead-blow’ basis rather than the sharp blow required by lithotripsy.