File:The Pathology and treatment of venereal diseases (electronic resource)- including the results of recent investigations upon the subject (1866) (14768022401).jpg

Identifier: 04801644.5817.emory.edu
Title: The Pathology and treatment of venereal diseases (electronic resource): including the results of recent investigations upon the subject
Year: 1866 (1860s)
Authors: Bumstead, Freeman J. (Freeman Josiah), 1826-1879
Subjects: Sexually transmitted diseases Sexually transmitted diseases Sexually Transmitted Diseases Venereology
Publisher: Philadelphia : Henry C. Lea
Contributing Library: Emory University, Woodruff Health Sciences Center Library
Digitizing Sponsor: Emory University, Woodruff Health Sciences Center Library

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lbous sound is passed through thecontraction, when the position of its posterior edge can be deter-mined by the bulb catching upon it in a to-and-fro motion impartedto the instrument; the difference in the readings upon the catheterand sound at a point corresponding to the external orifice of thecanal will clearly indicate the length of the stricture. This measure-ment is always desirable to aid in determining the probable durationof treatment, and is almost indispensable when external or internalincisions are employed. Again, the small size of the shaft gives tobulbous sounds, when passed through one contraction, considerablefreedom of motion, and enables the operator to explore for stricturesmore deeply situated. Bulbous bougies of gum elastic can be introduced with less pain tothe patient than bulbous sounds, and are, therefore, to be preferred,especially for exploring the deeper portions of the canal. Theseand knotted bougies ( bougies a nceuds ) are very valuable instru- Fig. 18.
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Bulbous and knotted bougies.1 (After Phillips.) ments for detecting a slight degree of contraction, and for deter-mining the comparative sensibility of the different portions of theurethra. Introduction of the Catheter.—A catheter may be introduced whilethe patient is in the standing or sitting posture, but the recumbentposition is on many accounts the best; the patient lying square on 1 These and the other instruments mentioned in this work may be obtained of Mr.Geo. Tiemann, 63 Chatham St., N. Y. 286 STRICTURE OF THE URETHRA. the back, with the shoulders elevated, the knees drawn up andsomewhat separated, the genital organs entirely exposed, and thesurgeon standing or sitting on his left. The operator now raisesthe penis to an angle of about sixty degrees with the body, therebyeffacing the anterior curve of the urethra, by means of the ring andmiddle finger of the left hand, its palm looking upwards; the thumband forefinger are thus left free to retract the prepuce and separatethe

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