Lectures on the American eclectic system of surgery . e in this lateral operation is afree external wound, and a small internal one. The widerthe former the shallower need be the latter. Care must betaken in withdrawing the knife, not to endanger the pudicartery by bringing it too near the ramus of the ischium. During the dilation of the deep wound by the finger, urineescapes; and commonly, the stone or stones descending withit, can now be distinctly felt. The staff is gently withdrawn.;and if the stone is found too large to pass through the openingalready prepared, a straight probe-pointed bi
Lectures on the American eclectic system of surgery . e in this lateral operation is afree external wound, and a small internal one. The widerthe former the shallower need be the latter. Care must betaken in withdrawing the knife, not to endanger the pudicartery by bringing it too near the ramus of the ischium. During the dilation of the deep wound by the finger, urineescapes; and commonly, the stone or stones descending withit, can now be distinctly felt. The staff is gently withdrawn.;and if the stone is found too large to pass through the openingalready prepared, a straight probe-pointed bistoury can bepassed over the forefinger still in the wound, dividing the pro-static portion of the urethra on the right side as well as on theleft, and then dilating as before. This bi-lateral incisioncan be made in the first place, when the calculus is knownbeforehand to be so large as to require 770 LITHOTOMY. The finger is kept in contact with the stone until it is seizedby the the forceps^(represented by Fig. 143). These should be Fig. 143. large enough in the blades to hold the calculus by as manypoints as possible, and long enough in the bandies to furnishsufficient leverage; while for other obvious reasons, it shouldbe as small as will meet these conditions. To lessen thechance of the stones slipping, the blades of the instrumentmay be lined with cotton cloth. If the stone is not imme-diately clutched, the point of the forceps should be advancedand depressed to the part where it is most likely to be object being seized, it is to be turned round with the for-ceps, to be certain that no part of the bladder is included, andthen elevated and taken out, the. finger being again insertedbetween the blades of the instrument, to ascertain that thecalculus is in the best position, or to put it so if required. Itslongest diameter being adjusted in the axis of the instrument,and that in the direction of the axis of the pelvis, obliquelydownward, extractive force is s
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Keywords: ., bookcentury1800, bookdecade1860, booksubjectgeneralsurgery, booky
