Litholapaxy or rapid lithotrity with evacuation / by Henry J. Bigelow.

  • Bigelow, Henry Jacob, 1818-1890.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Litholapaxy or rapid lithotrity with evacuation / by Henry J. Bigelow. 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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    been stated by Sir Henry Thompson. But he recommends for the glass cylinder or trap which is to admit this tul)e a “per- foration at the end, tlie size of a No. 14 catheter,” = 25 Char- riere.^ This perforation is too small; and the tube which is designed to enter it is further reduced by its collar to the diameter of only 12, = 21 Charriere. In fact, this is the calibre of the evacuating catheters now attached to Clover’s instru- ment, and is of itself fatal to their efficiency. An effective tube has a calibre of 28 to 31 or even 32 Charriere, and the meatus, which is the narrowest part, may, if necessary, be slit to admit it, if the urethra is othervAuse capacious. Again, in the instrument, as sometimes constructed by Weiss, a joint is made by inserting an upper tube into a lower one, thus obstructing the calibre bj^ a shoulder. The joints should became larger as the tube approaches the bottle, so that the tube may deliver without difficulty fragments of its own calibre. Whatever be the size of the evacuating tube, the rubber tube, with its metal attachments, should have a calibre of at least seven sixteenths of an inch, = 31 Charriere. My evacuating tubes are of thin silver, of sizes 27, 28, 29, 30, and 31, filiffi’e Charriere, respectively. (2.) Shape of the tube. Works upon lithotrity enumerate and figure a variety of tubes through which fragments are to be aspirated. Many of these are useless. The best tube is a straight one. (Figure 2 a.) That which is curved quite near the extremity is designed to be used with the curve inverted and directed downward, the orifice then looking forward. (3. ) Shape of the receiving extremity. The receiving extrem- ity should depress the bladder when required to do so, and thus invite the fragments, while its orifice remains unobstructed by the mucous membrane. Upon the floor of the bladder, when not indented, a fragment of stone, lying at the distance of half or even quarter of an inch from the tube extremity, may not be attracted by the usual exhaust of the expanding bottle, which requires that the fragment should lie almost in con- tact with the tube. A very slight obstacle also impedes its entrance; and this fact renders inefficient all tubes like cathe- ters, with orifices along the side or u])per wall. Chips will not * Diseases of the Prostate, 4th edition, 1873, page 337.