The Richmond and Louisville medical journal . l give way at the roof, E, because it is the healthiest,and therefore the thinnest spot. In Fig. 4 the roof, C, is rep-resented as most affected, and if a knife be used it can be di- 222 STRICTURE OF THE URETHRA. vided at that spot, and a wound made with even edges, as seenat H, Fig. 5; but if a dilator (lacerator) be employed, the ure-thra will be rent in its most healthy portion, the floor, I, Supposing the left side of the urethra to be most involved,as viewed at K, Fig. 7, it can be incised at the desired spot, L,Fig. 8; but if laceratio
The Richmond and Louisville medical journal . l give way at the roof, E, because it is the healthiest,and therefore the thinnest spot. In Fig. 4 the roof, C, is rep-resented as most affected, and if a knife be used it can be di- 222 STRICTURE OF THE URETHRA. vided at that spot, and a wound made with even edges, as seenat H, Fig. 5; but if a dilator (lacerator) be employed, the ure-thra will be rent in its most healthy portion, the floor, I, Supposing the left side of the urethra to be most involved,as viewed at K, Fig. 7, it can be incised at the desired spot, L,Fig. 8; but if laceration be employed, the urethra will giveway at its weakest spot, M, Fig. 9. Finally, if the deposit beon the right side, N, Fig. 10, it can be cut where desired, asseen at 0, Fig. 11; but if torn, the healthy spot, P, Fig. 12,will give way. There are thus four separate conditions of thedisease, any one of which may be met with, in which the knifecan attack the diseased spot, whereas the dilator shirks theenemy and tears open the healthy It is thus seen that the surgeon who uses the knife knows thesituation and length of his incision, whereas he who employs adilator is entirely ignorant of the site and extent of the lacera-tion. The possession of the above knowledge is of the utmostimportance; for if an operation be followed by haemorrhage, thesurgeon, who is aware of the exact source of the bleeding, canadopt efficient measures for its arrest. But it may be said,how is a surgeon to know which portion of the urethra is dis-eased, and, if he did know, how can he so apply the knife as todivide it By using the bougie a demiboule, or a very fineinstrument made on the principle of Civiales extractor forurethral calculi, the exact position of the part most affected can STRICTURE OF THE URETHRA. 223 usually be made out, and then divided with a urethrotomewhich has its knife attached to a corresponding surface. Wehave now got a step further. We know exactly what we want— a cicat
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Keywords: ., bookcentury180, bookdecade1870, booksubjectmedicine, bookyear1876
