Operative surgery . one be detected, the number, size, and the probable consistence should bedetermined. The presence of two and even three calculi can be reasonablyestimated by careful manipulation with the searcher. However, this knowl-edge is best gained by the use of the lithotrite. If a stone be grasped bythis instrument the presence also of one at either side of the beak can be Thompsons searcher. Fig. 1344. Littles searcher. Fig. 1158 OPERATIVE SURGERY. determined with reasonable certainty by the alternating clicks attendingthe turning of the beak from si
Operative surgery . one be detected, the number, size, and the probable consistence should bedetermined. The presence of two and even three calculi can be reasonablyestimated by careful manipulation with the searcher. However, this knowl-edge is best gained by the use of the lithotrite. If a stone be grasped bythis instrument the presence also of one at either side of the beak can be Thompsons searcher. Fig. 1344. Littles searcher. Fig. 1158 OPERATIVE SURGERY. determined with reasonable certainty by the alternating clicks attendingthe turning of the beak from side to side. The size of the stone can be esti-mated ap])roximately with a searcher by noting the extent of the area offriction and distance of the exposure of the shaft of the instrument at themeatus when the beak is applied alternately to the anterior and posterior sur-faces of the calculus. The dimensions of the object grasped by a lithotritecan be accurately determined. The distinctness of the click will indicate. Fig. 1346.—Andrews searcher, with a tube to convey the sound to the ear. the hardness of the stone as a rule. A pasty stone will give a soft, low-pitched sound ; the reverse will follow contact with a hard one. A hardstone surrounded with organic matter may be mistaken for a soft the searching is completed apply warmth to the hypogastriuzn, givean anodyne and possibly ten grains of quinine, and keep the patient quiet. The Comments.—The ability to detect the click of small stones andfragments by aid of the searcher is greatly enhanced by the attachment ofthe so-called lithophone. This attachment can be extemporized by takinga piece of rubber tubing, twenty-five or thirty inches in length with aneighth of an inch caliber; double one end upon itself and place it againstthe handle of the searcher, allowing also the tubing continuous with it to liealong the handle, or push it into the open end of the handle of the other extremity is then place
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