File:Clinical lectures on stricture of the urethra and other disorders of the urinary organs (1878) (14595033770).jpg

Identifier: clinicallectures00harr (find matches)
Title: Clinical lectures on stricture of the urethra and other disorders of the urinary organs
Year: 1878 (1870s)
Authors: Harrison, Reginald, 1837-1908
Subjects: Urologic Diseases Urethral Stricture Urethra Urinary organs
Publisher: London : J. & A. Churchill Liverpool : Adam Holden
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ale ; whenit was 3£ inches, it would be 32 m., and so on inproportion. Upon these views as to the measurement of theurethra, Dr. Otis bases a method of treatment whichwill be referred to again when I come to treat of thevarious plans of practising urethrotomy. If we refer to a side view of the pelvic organs, wecan advantageously study the relations of the urethrato the surrounding parts (Fig. 3, from Grays Anatomy.) The curves of the urethra should here be noticed,with the view of determining the best position of theparts for the introduction of instruments along thecanal. If the operator were to attempt to pass a catheterwith the penis in a pendant position, it is quiteevident that he would have to encounter two curves, adifficulty which in the case of a rigid instrumentwould be found insurmountable ; whilst, on the other * British Medical Journal, Feb. 26th, 1876. SECOND LECTURE. 19 hand, the position of the penis may be so variedduring the operation as entirely to do away with one
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Sinus poaulaor Llricitius Cowjtters Clan 2?mflttc» Fig. 3. curve, and materially diminish the resistance of theother. It may be here observed that the urethra is onlyrigidly fixed at one part of its course, viz., as it passesthrough the triangular ligament. In front of this, itis sufficiently moveable to permit of the whole of thecanal being brought upon the same plane as the mem-branous portion which is contained between the twolayers of the triangular ligament. Hence a straightinstrument, such as the staff used by Key for litho- 20 SECOND LECTURE. tomy, may be introduced into the bladder quite asreadily as an ordinary curved catheter. It should be remembered that it is at the pointwhere the urethra passes through the triangular liga-ment the inexperienced operator meets with his great-est difficulty in passing a catheter, the point of theinstrument being usually allowed to drop so as topress against the ligament beloiv the urethral aperture.After noticing its curvatures, we should

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