Litholapaxy; Or, Rapid Lithotrity with Evacuation

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Williams, 1878 - 42 páginas

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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 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upon the penis next effaces this depression, and adds firmness to the urethral walls ; so that if the instrument be withdrawn a little, and...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 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 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 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 40 - ... calculus, although not necessarily pulverized, is crushed as rapidly and completely as is practicable. The dust and fragments are immediately evacuated, and a serious source of irritation is thus removed. 2. This can be generally effected in a single operation. 3. The operation — performed of course under ether — may be, if necessary, of one or two hours
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 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 6 - My own conviction is that it is better to protract the operation indefinitely in point of time, if thus the whole stone can be removed Avithout serious injury to the bladder.
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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