File:The Medical and surgical reporter (1887) (14770785891).jpg

Identifier: medicalsurgical561887phil (find matches)
Title: The Medical and surgical reporter
Year: 1858 (1850s)
Authors:
Subjects: Medicine Surgery
Publisher: (Philadelphia, Pa. : Crissy & Markley, Printers)
Contributing Library: Smithsonian Libraries
Digitizing Sponsor: Smithsonian Libraries

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ally ceased in a few days. In 1882 heobserved an appreciable lessening in the sizeof his stream. Shortly after this he had re-tention, and gradually grew worse, havingfrequent chills, and great distress in urinat-ing. Exploration showed the size of the 776 Comm unications. (Vol. lvi. urethra to be 12 mm. at the meatus, while atfive inches a capillary bougie fitted the con-striction tightly. I advised an operation, and performed iton August 7, 1886, first introducing awhalebone guide, and then over it a tun-neled dilating urethrotome (Fig. 5), which Ihere exhibit to you, which I had made forme by Tiemann & Co. eously, and has been discharging pus andurine ever since. He has several strictures,together with chronic cystitis and pyelitis. I operated on September 27th, 1886, bythe same method as in the preceding case,and laid open an extensive pus cavity in theperineal region. My patient did well forthree days, when I passed a No. 28 (French)sound, which was foilowed bv a severe chill
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Fig. 5. The instrument consists of parallel steelbars, the lower being segmented at a pointwhere the curve begins, and held together bybars which can be separated or closed bymeans of a button screw at the end. In the up-per bar is a groove into which the knife glides,and when not in use is concealed by a smallhalf bulb opposite the commencement of thecurve. The distal end of the instrument istunneled, measuring two millimetres in di-ameter. By means of this instrument, whena guide has been once introduced, we areable to cut a way through by just pushingthe knife forward from its concealment inthe bulb, and when it is once passed beyondthe point of constriction, the bars are sepa-rated by the button screw, dilating the ure-thra to the extent desired, that to be deter-mined by the indicator, when the knife isdrawn from behind forward, and the cica-tricial tissue divided. It will be seen thatthe instrument combines the properties of atunneled sound, a dilator, and a urethrotome. After d

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