1000000031

ln chis meehod che rcmarhble pares \\'ounded by che

kOlfe are, the

11Iu[culuJ

Irau[tJtr[cIIJ

prniJ,

It!vo/()r

ar.;,

.nd

projlrr/. glaJJd:

che old way, che uleehra only is

wounded , al.lout

tWO

¡oches on

Ihis

fiJe

lhe

prol1:te,

;;nu

•he lnllrumcncs are forccd ehrough ,he rell of Ihe palfage,

",hieh i. compofed of the bulbous pare of che ureenra, Ihe

membranous par! of t he urotb.. , che Dock of the bl.dder,

and proflate glaod . This channd

¡s io

very narrow, {hat,

till

be toro to pieces, (he

managelllent

of (he forceps is

exeeedingly diflieulc; and ie happe"s frequ <ncly. that from

the tender textUre of [he membranous paus, the forceps are

unwarily pu!hed through ; t botw«n the

os pubis

and bladder ¡

b.Gd"

that in introducing the gorget opoo the naif, j, is

apt .to nip dowowiTds be,w«o the reélum aod bladder,

both whích inconveniencic:s are avoided in [he latera) opera–

tion.

is true, the wound m..tde in the latcHI method

wiU

nOI

"dmit of the extraétion of a larze llane without la·

ceratioD as

\Vcll

as in

[he

old

w.y:

but in thcone cafe, the la·

c~ratioQ

is fmall, and made after a preparation for

byan

incifion; and

[he. .other, all the parts are lorn w'thout

I Oy

previous opening, and which are io very

tip,ht,

thar the

paio of the dillenfioo mufl oeedr"ily be <xcdlive. H ow–

cvcr, in both thert operations, the fu rgeon mutl

nOI

grarp

the none with .,¡olence

and even in extnél:ing,

mun,

with

both hands to the bnnches of his foretps,

refi¡t

their (hut·

tiog fo tight. as che comprellioo from che lips of fueh a

narrow wound would Olherwife

make

them . The extrae·

tion of very large floDes is mueh more

imprl:f.él.ieable

with

the gre..er 'pparaeus ehan by ,hi, mtthod, becaufe 'or che

fmaUnef. of the aogle or the booes i. thar pare where the

wound ;. mOlde; fo that indeed it is necdrary in "Imoa al!

extraélioDs tI) pull 'he O:one downward towuds tht rellum,

which cannot be done withom great violeDce to the mem·

branous pans, aad cven the (epuatiOD of one from anolhcr;

wheoce (ollow ·abfcelfe. and Ooughs about che wouod, which

a cireumllaoee nOI known in lhe lateral opcration.

Eco

"n.fú

(ollowed by fuppDratioo

~nd

gangrene, fomecime.

fpread themrelns upon the [erotum; and in /hon, alJ the

ineonveniences

¡nd

ilI

fymptoms which attend upon the

J¡.

teral operation, exeept the hremorrhage, are in a more vi ·

olent degrce incident

the old way .

An incontint>oee of urine is not eommon after (he lateral

ope ratio~.

and a fiflnla.fcldom ornever the confeqaenceoftt.

The manner of treating the patient after the opcralion,

i. preccy neuly ,his: [( it happeo. that the velTel. of Ihe

pro(late bleed. dry liot, or liot dipped io fnme nyptiá wa·

ur,

(ueh

a.s

IIfua

vi/ríoli,

mun be appHed tO the pan, and

held lhere ",i,h a cooGderable

de~ree

o( prelfure for

o (ew

houn; or a filver canula of three or four ¡oches long,

co~

"ered

with fine rag, may be introdueed into the bladdc!r, and

lert Ihere t\Vo or Ihree days, which feldo", (,ils eo (lop the

hOEmorrh;age. The pati!!ot may alCo uke an opiate. lf Ihe

wuund do.. OOt bleed, a Iiule dry liot. or. plodgi, of di–

geOi..

I.id

geotly io i,. i. belL The ploce ",here the pa·

tient lícs, {hould be

mod(f~tely

cool, as heat not only diC–

pofes the velfel. tO hleed arreCh, bu< generally m, kes him

Jow and faiot.

Ir,

roon after the operation, he complains

of a lieknefs at the num:\ch, or (Vea :\ paio in that pan of

the abdomen neu rhe bladJer, it is nOI always " (¡gn of a

dangerous jnR lmmation,

bUI

freCJ uently gocs off in

h~lf

hour:

"ffill,

h",wc:va,

in its rc:movat, a t"omentation pot

iOlo an hog's bladder, and applil·d preuy warm to rhe pare

í~

paio, will be of gre" ["fvice : if che

p.in

incrtAfos, af·

6G r

ter t\Vo or three hOllrs, the confcquence is much to be (cn.

ed¡ and io Ihls cafe, bloeding.

"n~

cmolli<nt c1)'Clcrs by

way of fOOlcnt;¡uion to, the bowds,

'uc

im!lh~cli

~c!y

De.

cefl"ary.

The fir(l good fyorpeom afeer che oprraeion is Ihe urioe

comlOg frccly away, as we then know Ihe I,ps of the! bl ..d·

der .nd pronale gland are OOt much ioR"ned.

,he fa–

tle~t

fhould becorne l<tnguid . and continue without any ap–

p:lne, bldlers. prove benefiei;l.l; which

may

be tlpplic-d with

great fafety. and little pain, as there

fcldom or ocvc:r

aoy IIraogury. Aboue the third or (ounh day a

110(.1

mufl

be proeured by a c1yUer; (or je feldom COOles oatuFally the

fir{l time, and thi, method mun be eontiouen as every man's

diferttion {hall guide him. As foon as the

p:il.tient

comes to

an appe eite, he !hould be iodulged in eating I.ghl rood; wieh.

this caution, that

be;:

do not eal too much at

time.

H, duriog the cure, che butlocks Chould be excorialed by

the urine. let them be aOOiDlt'd ",ith nutritum: the drer–

Gog from firft

lafl is feldom 4ny other chao a rofe digeC–

rife, or dry

lint .

Ofth.

STO"'

in Ih.

URETH''' '

lF a fmall flone be lodged in the urethr. near che glaO!

it "uy Orten

pu{hed out with Ihe fingers, or picked away

with fome iofiruOlent; bu[ if it llops

any other pan of

the channel , it may be

eu~

upon without any inconvenience.

The ben w.y of doin& ie. il 'o pull che prepuce over ,he

gl ..ns , as r;a as you can; aod thén fBaking an ¡Dcifioo the

Jenglh of the llone, through the tegumé nts,

may be turn–

ed oue with a little hook or the poine or a probe : The

wOtlnd of the fkin {lIPping back afterwards,

ils prGper

(j[U,uion, and froro the orifice of lhe

uret.hn

, prc\'eots the

ilTue of tbe urine through that orínce, and very oflen heals

in twenty.(our hours. This is a much Icrs painful method

o( eXlraéling floneo (rom the urerhra. chao by any iollr.u–

meots that have hitherto been devired.

Of lh. cxlraflion

oj'

Ih.

Stooe

\VO.,EN.

TH E

extraélion of the llone in women, will eafily be un ..

dcr!lood, Gnce the whole operalion eonfill$ in placing them

in (he: lame mAnner as men, and, without m,(king any wound,

illtrodueing into the bladder a llraight direélor, \apoo thu

a ;.orget, and afterwards the forceps

lO 14kc

hold of lhe

(loDe ¡ .11 which m.y be done ",iehout diflieul,y, by rea–

fon of ebe !hortoefs of lhe u,«hra.

the !luoe proves very

Jarge, and in C:Y..traéting dr:l\L's the bl"dder (orwards.

is.

advireable to make an ¡neifion through (he ncek of ¡t, upon

,he none; whleh not unly

WIJI

f..

cilitate the exuatlion, but

;)fo be leú dangerous Ihan a laeeration which will necef_

f:arily foJiow. The drdIings are fomentations and clllollieot

ointments, which fhould be applied \WO or three ttmes

dAY,

and the patient in other refpetls be treated Jike mell·

who have undergooe the opcratioDfor ,he llone.

EX.L ANATI ON ofFig.

Place

CLVII.

A found ured in fearchiog (or che (lone.

The fize reprefented here is but a liale tOO

I:lr~e

fur the..

you"gel! childrcn, aod OlOy be ofed upon boyo lill ehey ",o

lhirtecn or fou rteen years of age

a larger fhoulJ be em–

ployt!d betwcen lh.u agc and adultners

when one of ab.out

ten ¡oches, in a rip,ht line from (he lunule tO lhe !::'I:tremlty.

is proper. T hlS nlOuld b. made of ílecl, aDd ies e¡¡"emiey

be lounu 2nd fmooeh.

n,.