An American text-book of genito-urinary diseases, syphilis and diseases of the skin . ackof these precautions may perhaps result fatally for the patient. The patient 426 VESICAL CALCULUS. should not be examined in the physicians office and then sent away. It istrue that no serions consequences will follow in most cases when such acourse is pursued, but occasionally the physician will have cause to regrethaving done it. The administration of an anesthetic will depend on circumstances. Withelderly men, especially with those who have become used to passing a catheterbecause of prostatic enlargeme
An American text-book of genito-urinary diseases, syphilis and diseases of the skin . ackof these precautions may perhaps result fatally for the patient. The patient 426 VESICAL CALCULUS. should not be examined in the physicians office and then sent away. It istrue that no serions consequences will follow in most cases when such acourse is pursued, but occasionally the physician will have cause to regrethaving done it. The administration of an anesthetic will depend on circumstances. Withelderly men, especially with those who have become used to passing a catheterbecause of prostatic enlargement, and whose urethra? are not sensitive, itwill rarely be necessary, whereas with children it is usually better togive it. The surgeon should be equally able to pass the searcher from eitherside of the patient. If he stands on the patients right, the right, which isthe most practised hand with most operators, naturally manipulates the in-strument. The instrument should be held lightly between the thumb andfore finger and rotated gently from side to side; if there is a deep pouch,. Fig 329 —A perpendicular section through the bladder, median enlargement of the prostate and elon-gation of prostatic urethra : <i. greatly thickened bladder-wall; b, left lateral ot prostate; c, middleprostatic lobe; d. has fond of interiorof bladder, with small stone occupying it behind the hypertrophiedmiddle lobe (Watson). such as is present behind the projecting portions of an hypertrophied prostate,the beak of the searcher must be turned completely over in order to exploreit; when this is done the shaft should be depressed between the legs of thepatient. Small stones in this pouch are frequently overlooked through failureto do this. The stone will be more easily detected under these conditions ifthe pelvis is raised so as to roll it out of this pouch ; it is of equal advan-tage to keep this position during the operation of lithotrity. This point willbe referred to again when speaking
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Keywords: ., bookcentury1800, bookdecade1890, booksubject, booksubjectsyphilis
