A system of practical surgery / [Sir William Fergusson].

  • William Fergusson
Date:
1842
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / [Sir William Fergusson]. Source: Wellcome Collection.

    589/630 page 559
    EXTRACTION OF SMALL STONES. 539 and others, used the instrument like a syphon, — a dish with a com- municating tube being kept above, another below. A Read’s syringe may be applied for the purpose, and such an apparatus I have had by me for many years. A flexible caoutchouc catheter may be used on these occasions; silver, however, is generally preferred; and when Sir Benjamin Brodie injected nitric .acid, the catheter was made of gold. Mr. Weiss has lately constructed some instruments in the form of those which I have used, and had them gilt so that they will resist the action of any ordinary solvent. Instead of a single stone there may be several, or there may be nu- merous small concretions, varying in size from a mustard-seed to a garden-pea. In such examples the practice above alluded to may lie equally applicable, although there may often be every reason to sup- pose that some, if not all, of the little bodies are originally formed in the kidneys, and drop down the ureters into the bladder. Here it is evident that local measures alone will not suffice; but even while constitutional remedies are being exhibited some may advantageously be tried. Besides attempting to dissolve these objects, or possibly without trying such a plan at all, some method more strictly mecha- nical may be resorted to ; the urethra may be dilated to the fullest possible extent by means of bougies or otherwise, and thus there will be a greater probability of the gravel passing away in the na- tural stream; or a large catheter, provided with one or two large eyes, may lie introduced, and the cavity being distended with fluid, the small stones may pass along the tube, or possibly, in withdraw- ing it slowly, while the fluid is still in the viscus, a few may follow its point. Such plans have been known to suceed, as evinced in the practice of Ledran, Boyer, Sir Benjamin Brodie, and the late Mr. George Bell of Edinburgh,—who was thus fortunate in ridding a patient of one hundred and fifty concretions,—and in other instances the calculi have been seized with instruments made for the purpose, and extracted at once. The instance where Sir Astley Cooper was so successful as to cure his patient by extracting upwards of eighty small stones in this way, is the most celebrated of the kind. Mr. Weiss, who constructed the original instrument used for this case, has lately made it in some respects more perfect. This drawing (tig. 230) exhibits its shape and appearance: at the point it consists of two blades hollowed out within,
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image