Rapid Lithotrity with Evacuation

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Wm. Wood and Company, 1878 - 41 páginas

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Página 8 - ... ligament. Traction upon the penis next effaces this depression, and adds firmness to the urethral walls ; so that if the instrument be withdrawn a little, and...
Página 7 - Gross, Diseases, etc., of the Urinary Organs. Philadelphia, 1876. Page 232.) "Having used it [Clover's apparatus], very frequently, I would add that it is necessary to use all such apparatus with extreme gentleness, and I prefer to do without it, if possible.
Página 21 - ... upon it ; while the male blade, or stamp, offers a series of alternate triangular notches, by whose inclined planes the detritus escapes laterally after being crushed against the floor and rim of the shoe. At the heel of the shoe, where most of the stone is usually comminuted and where the impact is therefore greatest, the floor is high and discharges itself laterally, while its customary slot is made to work effectually
Página 3 - What human plan, device, or invention two hundred and seventy years old does not require reconsideration ? " he would no doubt have regarded with favor an occasional reconsideration of the theory and practice of medicine and surgery, — especially in view of the current belief that their traditions have been kept alive and their rules prescribed in part by authority.
Página 4 - ... followed by other symptoms, such as tenderness in the region of the bladder, a quickened pulse, and the frequent and painful passage of urine. These symptoms may insidiously persist rather than abate. Others may supervene. The surgeon vainly waits for a favorable moment to repeat his operation ; it becomes too evident that the patient is seriously ill, and it is quite within the range of possibilities that in the course of days or weeks he may quietly succumb. An autopsy discloses a variety of...
Página 6 - I believe that in any case which is as favorable to lithotrity as the average, in these days when stones are detected early, this can be effected ; and that if the bladder be completely emptied of detritus, we have as little to apprehend from the fatigue of the organ consequent upon such manipulation as from the alternative...
Página 29 - Third sitting: interval, five days; duration, three and three-quarters hours, under ether; size of tube, thirty-one ; quantity removed, seven hundred and six grains ; no pain nor discomfort afterwards; total number of grains, after drying, one thousand eight hundred and two. Result : discharged, well, two weeks from the date of the first operation ; after a few weeks the patient could retain his water from three to four hours.
Página 41 - Lastly, a non-fenestrated female blade protects the floor of the bladder, during a long sitting. A fenestrated instrument directs sharp splinters against it. The latter also delays the process of disintegration, by delivering through its opening the same fragments many times. 12. In locking and unlocking a lithotrite repeatedly in a long operation, it takes less time and is easier to turn the right wrist, as in my instrument, than to displace the thumb of either hand in search of a button or a lever,...
Página 21 - I like the blades of this instrument nearly so well as those of the fenestrated lithotrites by Weiss and Thompson already described. " The blades of this lithotrite consist of a shoe, or female blade, the sides of which are so low that a fragment falls upon it ; while the male blade, or stamp, offers a series of alternate triangular notches by whose inclined planes the detritus escapes laterally after being crushed against the floor and rim of the shoe. At the heel of the shoe, where most of the...
Página 4 - ... removal of the offending fragments as a last resource. But if at the first operation the bladder could have been completely disembarrassed of every particle of stone, even with the risk of irritating its lining membrane, we can hardly doubt that the relief would then have been followed by ready repair. In short, it is difficult to avoid the conviction that in an average case damage to the mucous membrane, and quite as great, is as likely to follow the persistent irritation by angular fragments...

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