File:The Canadian journal of medicine and surgery (1897) (14578138258).jpg

Identifier: canadianjournalo05torouoft (find matches)
Title: The Canadian journal of medicine and surgery
Year: 1897 (1890s)
Authors:
Subjects: Medicine Surgery
Publisher: Toronto
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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AN JOURNAL OF ILird vubher sounda. The most coiiveniuut ul these lias aslijrht olivary enlargement of the tip, towards which the shaft ofthe sound is somewhat more supple than its stem. In the beoin-iiino of treatment, when there is likely to be considerable urethralhyper;i3sthesia, or even only normal sensitiveness, the rubber soundsshould be o-iven preference. I desire here to aoain lay stress uponihe fact that the office of sounds never is to produce forcible dilata-tion of the urethra. Their only purpose is, as the grand master ofgenito-urinary work, Professor Guyon, says, to exercise a dynamicinfluence. Therefore no sound should ever be used laigerthan onethat Mill readily slip through the urethra. The promptness withwhich even heavy contractures will yield to the mere presence of asound is sometimes astonishing. I have in mind a large number ofcases, in which the patient could with the greatest effort expel buta few <lrops of urine : thej were strictured so that but a hliform
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Fiii. 4—Guvoii sound. would pass. It is nothing extraordinar)^ to see such urethrasreadily transmit a 19 or 20 F. within ten to twelve days, withoutonce employing the slightest force. Metal sounds. Usually when the ui-ethra will comfortablyliold a 24 F. rubber sound, it will not l)e disturbed by the passageof a 23 metal sound. The shape of the sound then comes intoconsideration. For general purposes the old Beni(iue sound is themost serviceable. Its shape is likely to appal those accustomed tothe straighter shapes. But a little anatomical consideration willrecall that the urethral curves, especially in the fixed portion, aremuch stretched b) the straight sounds, and in a practical senseboth physicians who u.se the Bdnique sounds and their patientsprefer them. By gentle handling they are more safely and easilyintroduced than others in the majority of cases. A modification of this instrument is the Guyon sound. Pro-fessor Guyon, with the modesty that chaiacterizes greatness,persists i

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