File:The homeopathic practice of surgery - together with operative surgery (1855) (14596687307).jpg

Identifier: 66810730R.nlm.nih.gov
Title: The homeopathic practice of surgery : together with operative surgery
Year: 1855 (1850s)
Authors: Hill, B. L. (Benjamin L.) Hunt, Jas. G. (James George), b. 1822
Subjects: Surgical Procedures, Operative Homeopathy
Publisher: Cleveland, O(hio) : J. B. Cobb and Co.
Contributing Library: U.S. National Library of Medicine
Digitizing Sponsor: Open Knowledge Commons, U.S. National Library of Medicine

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
tion. The perineum must be previously shaved clean.The knife used has the posterior two-thirds of the edge blunt: itis somewhat longer than the common scalpel. This enters theperineum about midway between the scrotum and anus, on the leftside of the raphe, and is brought downwards and outwards, divid-ing only the skin and superficial fasciae to about midway betweenthe anus and the tuberosity of the ischium. The section is thendeepened by the finger, for the purpose of security to the rectumand to blood-vessels. Muscles also should be separated ratherthan torn. If any portions of the levator ani resist the fingerthey must be divided by the knife. So also with the transversaperinei, though that muscle is often wanting. The point of theknife has to be applied with great care to any part that resists LITHOTOMY — OPERATION — MANIPULATION IN 209 dilatation. The finger-nail is lodged in the groove of the director,just in front of the prostate and behind the triangular ligament. Fig. 136.
Text Appearing After Image:
The knife is made to perforate the urethra and enter the groovebehind the finger (as shown in Fig. 136), which simultaneouslyfollows.it, entering the urethra, which the knife divides far enoughfor the purpose. The finger moves freely on the dilatable sub-stance of the prostate. The base of that gland is not divided;and the ileo-vesical fascia is left entire, to prevent the danger ofurinary infiltration. An incision just large enough for the en-trance of the finger can be easily dilated for the exit of ordinarysized calculi. The rule in this lateral operation is a freeexternal wound, and a small internal one. The wider the for-mer, the shallower need be the latter. Care must be taken mwithdrawing the knife, not to endanger the pudic artery by bring-ing it too near the ramus of the ischium. During the dilatation of the deep wound by the finger, urinescapes; and commonly, the stone or stones descending with it,-an now be distinctly felt. The staff is gently withdrawn; andif the stone is

Note About Images