The Hahnemannian monthly . itches of silkworm-gut or other non-absorbent andnon-absorbable material. A little gauze may be packed aroundthe catheter if the wound is too large. This catheter may beleft in place without changing for a week or ten days, if nec-essary, until granulation of the suprapubic wound has wellprogressed and there is no further danger of urinary infiltra-tion. One may theorize as much as he pleases regarding theslight danger of urinary infiltration in suprapubic lithotomy 1899.] Suprapubic Lithotomy in Aged Men. 11 without perineal drainage, but an unfavorable personal exp
The Hahnemannian monthly . itches of silkworm-gut or other non-absorbent andnon-absorbable material. A little gauze may be packed aroundthe catheter if the wound is too large. This catheter may beleft in place without changing for a week or ten days, if nec-essary, until granulation of the suprapubic wound has wellprogressed and there is no further danger of urinary infiltra-tion. One may theorize as much as he pleases regarding theslight danger of urinary infiltration in suprapubic lithotomy 1899.] Suprapubic Lithotomy in Aged Men. 11 without perineal drainage, but an unfavorable personal experi-ence in one or two cases is very convincing that the clanger,especially in old men with loose tissues and diminished vitality,is a positive one, while with effectual perineal drainage thedanger is very much lessened. The upper wound should notbe closed with sutures but packed loosely with gauze, while atthe same time siphonage is kept up as much as possible bymeans of a double catheter. All the catheters should be con-. nected to long tubes which lead down to bottles standing onthe floor. It is needless to say that all these tubes, bottles, etc.,should be sterilized two or three times daily by boiling. Thedressing should be aseptic and as absorbent as possible, andshould be changed frequently. The drains to the suprapubicwound may be held in place by means of straps of adhesiveplaster which are fastened to the catheters by safety-pins whichare struck into the sides of the catheter, but do not invade itslumen. 12 The Ilahnemannian Monthly. [J anuary After granulation of the suprapubic wound is advanced, thearrangement which I show here is well adapted for holding thecatheter in place, and has the advantage of not slipping aboutand displacing the catheter. This apparatus, which is a modification of some already inuse, was made for me by Mr. H. R. Kirsten, and has provedvery satisfactory. It consists of a hard-rubber plate with acentral opening. Through the opening passes a go
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