Emergency surgery, for the general practitioner.

  • Sluss, John W. (John William), 1867-
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: Emergency surgery, for the general practitioner. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    MODI I \\< BORING \ I [LIFORM BOl GIE. with the iodoform glycerin solution and all the manoeuvres with the liliiorms repeated, often with the result that the first inserted will traverse the stricture and enter the bladder smoothly. The urethroscope is sometimes useful in locating the orifice, but even then the aliform may be difficult to enter, manifesting the per vcrsity of things inanimate; although the shortest urethroscope tube be used, the filiform will cling to its sides or will sway to and fro, touching every point of the exposed region except the orifice. Under the tin umstances, the Valentine-Townsend filiform carrier (Fig. 458) is to be recom- mended and its use is thus described: After the urethroscopic tube is in- serted, the urethral mucosa dried, and the light in place, the carrier, armed with a filiform, is inserted. The lowermost ring containing the filiform's tip is pressed against the face of the stricture at the point where its lumen is visible. Once fixed by slight pressure, the filiform is very slowly projected into the exposed lumen. If it fails to traverse the stric- ture, an angular and then a corkscrew filiform are tried as before described. Whenever a filiform reaches the bladder, the fact is announced by the ease with which the instrument can be moved to and fro, and by the increased desire to urinate when the filiform touches the bladder walls, urine trickle by the filiform. The filiform must be fastened in place: No effort must be made at this time to pass a larger instrument. Valentine and Townsend recom- mend the following method of holding the filiform in place: Two pieces of sterile cord six inches long are used, one tied about the bougie in front of the meatus so that the knot corresponds to the dorsum of the penis, and the other tied so thai the knot corresponds 40 Fig. 459.—Cord attached to in- strument in urethra. {American Journal Surgery.) A few drops of