File:The diagnosis of diseases of women (1905) (14576823830).jpg

Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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the canalin the instrument. The usual technique of a cystoscopic examina-tion is carried out. In the Kelly-Pawlik method and preferably in the elevatedlithotomy position, as devised by Webster and Pryor, the catheteris directed through an endoscope after a thorough inspection ofthe bladder. In this method the instruments employed are a conicalurethral dilator, obturators, specula ranging in size from 8 to 10,head mirror, natural or artificial light, an evacuator, searcher, long,curved mouse-toothed forceps, and a flexible ureteral catheter.For special purposes there may be added hard-rubber bougies, ametal ureteral catheter, and a series of dilating catheters. After 534 DIAGNOSIS OF niSEASJES OF THE URINARY SYSTEM thoroughly inspecting the bladder as advised by Kelly the ureteralorifices are located by what is called a searcher. When no diffi-culty is experienced in locating the ureteral orifice or prominencethe searcher may be dispensed with and the catheter at once directed Fig. 220
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Simultaneous catheterization of the ureters. The urine may be collected from eitherkidney in separate sterile tubes and for an indefinite period. The above method is suggestedby Kelly. to the ureter. A metallic searcher is made to lightly impinge againstthe mucous membrane in the supposed location of the ureteralorifice. No force is to be used for fear of perforating the bladder.The searcher separates the lips of the orifice, which now presenta dark, rounded opening, and is allowed to drop into the ureter DIAGNOSIS OF DISEASES OF THE URETERS 535 by its own weight. It serves as a guide to the catheter, which isdirected to the ureteral orifice. As the catheter enters the ureterthe searcher is withdrawn by an assistant. A -flexible catheter has many advantages over one made of metalor non-flexible rubber. It readily follows the course of the ureterto the pelvis of the kidney, and there is little danger of injuring theureter. When it is desired to catheterize the ureter without enter-ing

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