. Tri-State medical journal . f by a lithotrite. The former (which have been made for me byMessrs. Krohne & Sesemann) are constructed with a cutting rib enclosedwithin the forceps, by which, either by the hand alone, or by the screw atthe handle, any stone thus fairly grasped is rapidly broken up by one ormore applications of the instrument. Oxalate, urate, cystin, and phos-phate calculi of considerable dimensions, as you see in the specimens be-fore you, have thus been reduced to fragments in a few minutes, and safelyremoved from the bladder. 382 Original Articles. The chief points in favor o
. Tri-State medical journal . f by a lithotrite. The former (which have been made for me byMessrs. Krohne & Sesemann) are constructed with a cutting rib enclosedwithin the forceps, by which, either by the hand alone, or by the screw atthe handle, any stone thus fairly grasped is rapidly broken up by one ormore applications of the instrument. Oxalate, urate, cystin, and phos-phate calculi of considerable dimensions, as you see in the specimens be-fore you, have thus been reduced to fragments in a few minutes, and safelyremoved from the bladder. 382 Original Articles. The chief points in favor of this operation are these: — (l) It enablesthe operator to crush and evacuate large stones in a short space of time;(2) it is attended with a very small risk to life as compared with other ope-rations, such as lateral or supra-pubic lithotomy; (3) it permits the opera-tor to wash out the bladder and any pouches connected with it more effectu-ally than by the urethra, as the route is shorter and the evacuating catheters. Fig. 2. Fig. 3. Fig. 4. Fig. 1. employed of larger calibre; (4) the surgeon can ascertain, either by explo-ration with the finger or by the introduction of the forceps, that the bladderis cleared of all debris; (5) it enables the surgeon to deal with certainforms of prostatic outgrowth and obstruction complicated with atony of thebladder in such a way as to secure not only the removal of the stone, butthe restoration of the function of micturition; (6) by the subsequent in- Clinical Lecture-Harrison. troduction and temporary retention of a soft rubber drainage-tube, states ocystitis due to the retention of urine in pouches and depressions in thebladder wall are either entirely cured or are permanently improved. Tolock up unhealthy ammoniacal urine in a bladder that cannot properlyempty itself after a lithotrity, is to court the formation or recurrence ofa phosphatic stone. I will conclude by briefly narrating the particulars of two cases asillustrating points
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