File:The operating room and the patient; a manual of pre- and post-operative treatment (1913) (14592928209).jpg

Identifier: operatingroompat00fowl (find matches)
Title: The operating room and the patient; a manual of pre- and post-operative treatment
Year: 1913 (1910s)
Authors: Fowler, Russell Story, 1874-1959
Subjects: Operating Rooms Patients
Publisher: Philadelphia,: Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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in theright hand, the palm of the latter directed toward the patientsfeet. The beak, of the instrument is introduced with its shaftheld over the groin and almost touching the skin, until it passesthe penile urethra or until all of the curve and an inch or moreof the shaft has disappeared. Only the gentlest pressure isemployed. The penis is drawn over the catheter, the beakfollowing the roof of the canal. As the extremity of the catheterreaches the cul-de-sac of the bulb, as determined by the little 216 OPERATING ROOM AND THE PATIENT finger of the hand that holds the penis, the instrument entersthe membranous portion of the urethra, thus completing thefirst stage of the operation (Fig. 149). In the second stage the handle of the instrument is carriedto the median line. The shaft is kept well back toward thesurface of the abdomen, almost touching the latter. As thebeak adapts itself to the subpubic curve the penis is releasedand the scrotum grasped in the hollow of the left hand, while
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Iig. 150.—The second stage in the techxdc of catheterization. (Fowlers Surgery.) at the same time the parts are pressed against the pubis andupward traction made (Fig. 150). The instrument is nowgently advanced until its point lies well against the pubis,when the scrotum, testicles, and penis are released and theinstrument transferied to the left hand. In the third stage the instrument is steadied in the medianline by the left hand and its shaft carried away from the surfaceof the abdomen (Fig. 151), the handle describing the arc of acircle during this part of the manipulation. This movement isto be continued until the handle of the instrument almost GENERAL CONSIDERATIONS IN THE AFTER-TREATMENT 217 reaches the meatus. The right hand now makes pressure in adownward direction on the root of the penis to stretch thesuspensory ligament and diminish the curve of the membranousportion of the urethra (Fig. 152). At the same time the instru-ment is depressed between the thighs and sHps int

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