The surgical treatment of the diseases of infancy and childhood / by T. Holmes.
- Timothy Holmes
- Date:
- 1868
Licence: Public Domain Mark
Credit: The surgical treatment of the diseases of infancy and childhood / by T. Holmes. Source: Wellcome Collection.
Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.
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![the mucous membrane of the urethra—an accident very liable to occur in childhood. Sounding should be conducted method- ically and deliberately. The sound should first be pushed down to the fundus of the bladder, i. e. with its convexity pressing towards the rectum. In nine cases out of ten, when a stone is present, it will be struck immediately by this movement. If not, the point should be turned, first to the left, then to the right side of the bladder, and finally reversed, in order to feel every part of the interior, and pro- vide for the very rare case of a cyst be- tween the bladder and rectum. Some- times it is desirable to change the child's position, by elevating the pelvis or by making him stand up. In cases where much doubt exists, it is unquestionably wise to assist the sound with the left fore- finger in the rectum. The stone may be often thus felt; but I cannot say that, as yet, I have ever diagnosed a stone in this way which I could not feel with the sound in the usual mamier. StiU, in the very rare case alluded to above, if the stone were encysted towards the base of the bladder, the sound might pass over it, while the finger might lift it out of the cyst and bring it into the way of the instrument; or it is even conceivable that the stone might be caught between folds of the bladder, and might be disengaged by the finger. I therefore usually explore the bladder in tliis way ; but I attacli little weight to it, and still less to the use of the stethoscope, or the application of the ear to the abdomen to hear the ring of the stone; though there is, of course, no objection to this. [Pig, 93. The catheter- Bound.]](https://iiif.wellcomecollection.org/image/b21511469_0624.jp2/full/800%2C/0/default.jpg)
