A treatise on the formation, constituents, and extraction of the urinary calculus : being the essay for which the Jacksonian Prize for the year 1833 was awarded by the Royal College of Surgeons in London / by John Green Crosse.

Date:
1835
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the formation, constituents, and extraction of the urinary calculus : being the essay for which the Jacksonian Prize for the year 1833 was awarded by the Royal College of Surgeons in London / by John Green Crosse. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    parts, or when the bladder is much thickened you will estimate the stone to be larger than it really is. When the bladder contains a few ounces of urine, and the stone is not of considerable size, it gives so evasive an impression to the finger in ano, that much practice is required to profit by this examination, and to tell that you feel a stone; but where this foreign body is very large, it can always be felt by the rectum, unless there be a greatly enlarged prostate gland or other tumour interfering. In this method of exploring the bladder, the patient is placed hori- zontally on the back, or with the shoulders raised; but the surgeon has more command, and sometimes facilitates his object, by making the patient stand on a bed or table; if the bladder be empty, only gentle pressure with the finger should be made, as it will injure the lining membrane, particularly if the calculus be rough on the surface. I have known so much mischief arise from the undertaking of operations for stone without previously examining by the rectum, that I am induced to represent forcibly the propriety of doing it in every instance; I should deem myself as little justified in omitting this method of exploration, as in oper- ating without having sounded at all. It has been recently suggested to use a sound with a very short curve,6 such as fig. 4 of plate xxviii, in order that, when introduced into the bladder, it may be turned round upon its axis, the part occupying the urethra being straight; its curved end will thus describe a circle in the bladder, and pass behind the prostate gland, searching the bas-fond of this organ, which is just the part of its cavity least accessible, sometimes quite inaccessible, to the long curved sound. A late eminent surgeon7 gave me, twenty years ago, a catheter shaped like one of the sounds now referred to, and assured me he had sometimes found it enter the blad- der, when an instrument of a different shape would not. It is right to have at hand an instrument thus shaped, and to take advantage of this circular movement of its curved part in the bladder; but it appears to me that neither this nor the 6 Baron Heurteloup (Principles of Lithotrity) gives the name of recto-curvilinear sound to an instrument of this shape, and may perhaps be regarded as the first surgeon who suggested rotatory sounding. 7 Mr. John Pearson, of London.