The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . sounding with the lithotrite. The hardness of the stone may usually be judged of by the more orless clear ringing character of the click ; a lithic acid or oxalate of limecalculus giving a sharper sound tlian a phosphatic concretion. JU CALCULUS. A calculus may generally be known to be encysted if the sonnd strikeit at times, but not at others (Fig. 728); if the stone always appear tobe fixed in one situation ; and if the beak of the instrument cannot bemade to pass round it, so as to iso
The science and art of surgery : being a treatise on surgical injuries, diseases, and operations . sounding with the lithotrite. The hardness of the stone may usually be judged of by the more orless clear ringing character of the click ; a lithic acid or oxalate of limecalculus giving a sharper sound tlian a phosphatic concretion. JU CALCULUS. A calculus may generally be known to be encysted if the sonnd strikeit at times, but not at others (Fig. 728); if the stone always appear tobe fixed in one situation ; and if the beak of the instrument cannot bemade to pass round it, so as to isolate it, but a kind of tumor projectingthrough the walls of the bladder is felt, around or on one side of thepoint where the calculus is Fisf. 72S.—Sounding for Encvsted Calculus. The fasciculnted, roughened, and sacculated condition of the Maddermay generally be detected by the way in which the beak of the instru-ment grates and rubs over the organ. The aize of the calculus is best determined by a lithotrite. It is truethat a Surgeon may sometimes come to a decision as to the bulk of acalculus, by observing tiie extent of surface along which the sound is incontact with the stone, as the instrument is being withdrawn. But avery rough guess only can be arrived at in this way ; and I have fre-quently seen very experienced Surgeons deceived in their estimate of thesize of the calculus, mistaking perhaps several small ones lying togetherfor one large one. By introducing a lithotrite and seizing the calculusgently between its blades, a correct estimate of its size maj^ always bearrived at. In order to determine that several calculi exist in the bladder, it issometimes sufficient for the Surgeon to feel that the beak of th
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