Case of a foreign body in the bladder, with stricture of the urethra / by Edward Lund.

  • Lund, Edward, 1823-1898.
Date:
[1872]
Catalogue details

Licence: Public Domain Mark

Credit: Case of a foreign body in the bladder, with stricture of the urethra / by Edward Lund. 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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    it about in all directions, I could not succeed in even touching the foreign body. In these attempts I was assisted by Mr. Smith and Dr. Carruthers; and after trying in the most persevering manner for some time, we almost felt disposed to give it up in despair ; when it occurred to me that, as we had only tried with the bladder distended, we ought to draw off the water, so as to explore the bladder when in a less expanded, or even in an empty state. In this we were much more successful, for on the re-application of the lithotrite Dr. Carruthers was enabled to indicate what he thought was the position of the catheter, it being, as he conjectured, on the patient’s right side. Following this suggestion, I took hold of the instrument, and very quickly succeeded in catching a portion of it between the blades of the lithotrite; these being fixed by the screw action of the instrument, I drew it out through the urethra' having seized it and held it exactly in the way shown in the accompanying heliotype drawing. The bladder was washed out with warm water, through a No. 10 silver catheter, which entered easily, for the stricture was entirely destroyed. The patient was put to bed ; quinine and opium were administered; and the general treatment was conducted according to the instruc- tions laid down by Mr. Holt in his description of the after- management of such cases. The patient seemed to go on very favourably for three days, but on the fourth day, without my permission, he got up, dressed himself, and went down stairs. In the evening I found he had great difficulty in passing his urine, which up to this time had been voided in a full stream with little pain. The jiulse also had been quiet and no febrile symptoms had existed, but now he com- plained of a sickly feeling ; rigors were occasionally experienced to a slight degree, and he felt as if he had no power to empty the bladder. I therefore passed a No. 10 catheter, which gave him some pain, and drew off some urine which was tinged with blood. How far this was caused by the passage of the instrument, or by the hemorrhage resulting from the rent in the urethra, which had bled into the bladder, I cannot say. During the whole of this night he was extremely feverish, with occasional rigors, and all the symptoms which are associated with