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.

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    membrane of the urethra, its folds, rugte, &c., I think we may safely say, that the noosing plan would be tedious and uncertain, if not of doubtful utility. \ And lastly, the scoop shaped like a hook could not be easily! passed by a calculus which was sufficiently large to fill up thei urethra, so as fairly to hook upon and to act efficiently on its pes-; terior extremity. j When the calculus is lodged some distance back from the orificej of the urethra, and cannot be dislodged or extracted by any of the! above means, authors recommend urethrotomy, or cutting through' the urethra upon the stone, at its under side, and thus extract the] foreign body. In this way there is not much difficulty in extract-j ing the calculus ; but the danger of a fistula, and the trouble of a. long process of treatment, and the uncertainty of effecting a cure,; should lead us to hesitate and to exhaust all other reasonable ex-| pediencies before resorting to the use of the knife. ! It has fallen to my lot to have had the management of some teni or a dozen cases of urinary calculi in the urethra. I have alsoj seen several cases of fistulous openings in the urethra, and iu two! instances failed to close them up, by any and all the varied means' which I zealously and persistently brought to bear upon them. The cases of lodgment of calculi in the urethra that have fallen^ under my ol)servation have been mostly in small boys. I can now bring to mind a very interesting case of a small boy, abouti six years of age, who had Ijecn attended for some days, or nearly a week, by a country physician, for suppression of urine. Diu-i retics and warm fomentations had been employed freely, till the; bowels, as the physician supposed, had become enormously: distended. On making inquiry as to the history of the case, audi on percussion, I said to the doctor, The bladder of your patient; is full of urine, and there is great danger of the urethra givingj way, as the penis and urethra were much infiamed near thej testes. As the urine had been passing away from the little patient; almost guttatim, I presume the attending ph3'sician had supposed; the bladder was emptying itself. I attempted to pass the catheter! into the bladder, and after traversing the urethra about an inch' and a half, it came in contact with an obstruction—what appeared^ to be some foreign body—in short, like a small calculus. The| catheter was withdrawn, and by the aid of the fingers, the stone^ was soon worked forwards to the orifice of the urethra, when it! became necessaiy to divide it in the direction of the frenum before!