File:The homeopathic practice of surgery - together with operative surgery (1855) (14780843854).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

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anyportion of the bladder. The best prospect of success in the use of the lithontriptor iswhen the urethra and bladder being sound, the prostate in a nat-ural condition, and the patient an adult, the stone is both small 206 OPERATION OF LITHONTRIPSY. and soft. If any of these conditions are wanting, lithotomy isthe only resort. Children are, of course, excluded from the listof cases for lithontripsy, by the narrowness of their urethra. FOR THE OPERATION OF LITHONTRIPSY, — the patient is placed on a table covered with quilts; thehips are elevated so as to throw the stone back from the mouthof the urethra, and the bladder, if not already full of urine, is tobe nearly filled with tepid water, injected through a catheter.The urethra must have been previously dilated by the repeateduse of bougies, increasing the size, from time to time, for a weekor more, until the lithontriptor will enter. This instrument (Fig.135) is then warmed, oiled, and passed in, closed up, as a common Fig. 135.*
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sound or bougie. When it comes in contact with the stone, themovable half is pushed in so as to open the blades at the joints,and form a sort of firm loop or noose. Rotate this from side toside, and tighten a little occasionally, so as to grasp the stonewhenever it gets into the loop. As soon as it is fixed between theblades, as represented in the above drawing, which will be knownby your inability to draw the sliding half back, turn graduallyupon the arms of the screw, which slowly, but with great force,draws out the slide, and brings the blades together. When thestone gives way, and the instrument closes, re-open it and ma-noeuvre as before to catch any large fragments that may remain; * Drawn and engraved by G. K. Stillman, from the instrument as manufacturedby Max. Wocher, Cincinnati. LITHOTOMY — OPERATION. 207 continue this until all are finely crushed; then withdraw the in-strument, and let the patient turn over, with his face downwards,and evacuate the fluid from the bladder

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