Practical lithotomy and lithotrity, or, an inquiry into the best modes of removing stone from the bladder / by Sir Henry Thompson.

  • Thompson, Henry, Sir, 1820-1904.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Practical lithotomy and lithotrity, or, an inquiry into the best modes of removing stone from the bladder / by Sir Henry Thompson. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    By a glance, and by passing the fingers over the peri- neal surface, he observes whether the tubera ischii are wide apart, or whether they approximate more than usual; and he plans the line of the first incision somewhat in confor- mity with the result of his examination. (See page 10.) [Different authorities give different directions respecting the mode of holding the staff. Some prefer the convex part slightly projecting in the left side of the perineum ; but the instructions given above describe the method which at the present day is pretty generally pursued by most experienced operators in this country.] II. The operator commences by introducing his left forefinger into the rectum to ascertain that it is empty ; a proceeding which appears also to have the effect of stimu- lating the bowel to contract and occupy the smallest possible space. He then places the fingers of the left hand upon the upper part of the perineal region to main- tain the skin in its place, not to draw it upwards ; and holding the sharp-pointed knife in his right, commences the first incision about a quarter of an inch to the left of the raphe, and an inch and quarter to an inch and half in front of the anus, carrying the blade downwards and outwards for about three inches in a direction about mid- way between the anus and tuber ischii, but inclining a little nearer to the latter. The knife should, at its point of entry, divide the skin, and quickly sink more deeply towards the staff, the situation of which should be kept in the mind's eye, into the superficial fascia and fat in the hollow which exists between the bulb and anus on the one side, and the ramus of the ischium on the other; this fossa corresponds, therefore, to about the upper half of the incision, which is to be gradually made more