A new method employed for removing a urinary calculus from the urethra / by Alden March.

  • March, Alden, 1795-1869.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: A new method employed for removing a urinary calculus from the urethra / by Alden March. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    5/11
    A NEW METHOD EMPLOYED \^ / ■' i FOR f^j \ mmm a urimry calculus from the urethra,! ^ V V Velpeau says : When calculi are found lodged behind the meatus, or in the fossa navicularis, it rarely happens that the eiforts of the bladder and the volume of the urine will not be found sutiBcient to expel them. But when these means do not succeed, he adds, we should proceed to search for them by the dressing forceps, the point of which is somewhat concaved and flattened ; or, as Sebatier recommends, by gliding underneath them a noose of iron or brass wire by means of a small scoop shaped like a hook ; or. finally, if these should fail, or l)c attended with too many difficulties, by incising the lower wall of the urethra in front of the stone. Before we proceed to comment upon the above manual or mechanical means of extracting a calculus from the urethra, it will be proper to notice the sheathed force])s^ an instrument somewhat of the character of that used for holding the stone in the process of drilling, and thus breaking it up, as practiced many years ago by Civcale. A similar instrument has been used for extracting bullets. The instalment herewith exhibited will give some idea of its design, and how eflSciently it may be employed for either purpose. I will remark, howe\er, that I never used it successfully in extract- ing a ball, but on one occasion I employed it with complete suc- cess in extracting a calculus from the foi-epart of the urethra of an adult. We think the dressing forceps can hardly I)e made available if the calculus is lodged more than an inch I)ack of the fossa navicu- laris, for the simple reason that the orihce and anterior part of the urethra would prevent the blades from being sufhciently opened to permit grasping the stone. Those of us who have practiced noosing a bottle cork, when lodged in the bottle, with a piece of twine or wire, and have ob- served the manner in which the noose acts on the cork, to turn it diagonally, or more or less crosswise in the neck of the bottle ; and especially, when we consider the lax condition of the lining