File:A system of genito-urinary diseases, syphilology and dermatology (1893) (14577607098).jpg

Identifier: systemofgenitour01morr (find matches)
Title: A system of genito-urinary diseases, syphilology and dermatology
Year: 1893 (1890s)
Authors: Morrow, Prince A. (Prince Albert), 1846-1913, ed
Subjects: Skin Syphilis Genitourinary organs
Publisher: New York : Appleton
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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e to come. The wedging of a fragment in the tube causes an obstruction which isvery noticeable. The compression of the bulb is rendered difiicult, andits expansion slow. An angular fragment may lodge so that, while itallows the passage of water, it prevents the entrance of other fragments.This condition may be suspected if there is a constant clicking against the tube, and still nothing appears in the reservoir. The usual point44 690 STONE IN THE BLADDER. wliere fragments wedge is at the mouth of the tube. When one thusbecomes fixed, it maj be dislodged with a stylet, and this is the safestmethod of disposing of it, although with care the tube may generally bedrawn out with the fragment in it. This procedure, however, is not de-void of danger, for sharp, projecting angles may lacerate the urethra, ora bit of stone may remain sticking in the passage. The tube may also be obstructed by the bladder wall, which is some-times sucked into the orifice. The stoppage from this cause is usually
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Fig. 51.—Showintc the manner of liolding the bulb. The left hand holds the weight while theriglit manipulates it. not continuous, but the walls flapping against the opening give the in-strument a series of jerks which remind one of a fish-bite. When this isfelt the instrument should be moved to another part of the bladder; and,if it then occurs, it shows that the bladder is not sufiiciently distended,and water should be added through the hose at the top of the bulb.Pumping should be prolonged until the sand and gravel cease to come.Then the lithotrite should be again introduced and the crushing con-tinued, followed again, as before, by the washing out. Finally, after thestone has been thoroughly crushed, and when for several minutes nofragments appeal in the reservoir, it is evident that the evacuation is LITHOLAPAXY. 691 almost completed; and now begins a very important part of the opera-tion—namely, the search for the last fragments. The tube should bemoved to different parts of

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