A system of practical surgery / by William Fergusson.

  • Fergusson, William, Sir, 1808-1877.
Date:
M.DCCC.XLII [1842]
Catalogue details

Licence: Public Domain Mark

Credit: A system of practical surgery / by William Fergusson. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    extraction than that behind: besides, an incision which is begun an inch and three-quarters or two inches in front of the anus, Avhen the scrotum is held up in the manner recommended, will not appear so high after the parts are allowed to resume a more natural position. The skin alone should be divided in front, and between the tuberosity and the anus the blade may be carried deeper, although there is less occasion for this in general than some have supposed. The young surgeon is often told to cut freely here, because there is no important texture,—nothing but cellular tissue; but where the stone is not above an average size, there is actually no need of a wide gap in this situation. A free division of the skin I consider a most important feature in the operation; but beyond this the application of the knife should, in my opinion, be extremely limited. The point of the finger may, in general, be thrust without much force into the space between the accelerator urinae and erector penis, provided the superficial fascia has been cut; it will then probably be arrested by the transversus perinei muscle, the lower part of the triangular ligament, and some of the fibres of the levator ani; but I believe the groove may be felt through these parts,—they may in a manner be squeezed up against it, and the puncture with the knife as it is carried onwards will usually suffice to admit the point of the finger, which, being accomplished, gives the operator the power of enlarging the wound to such an extent as to permit the introduction of the blades of the forceps. The dotted Fig. 459. lines, leading from the surface of the perineum in the accompanying drawing (fig. 459), will give an idea of the extent of the wound as far as the membranous portion of the urethra : the left forefinger is placed on that part as above recommended: the point of the knife is repre- sented as being about to be carried onwards, and the dark line on the