File:The science and art of surgery - being a treatise on surgical injuries, diseases, and operations (1878) (14802461643).jpg

Identifier: scienceartofsurg02eric (find matches)
Title: The science and art of surgery : being a treatise on surgical injuries, diseases, and operations
Year: 1878 (1870s)
Authors: Erichsen, John Eric, 1818-1896
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : H.C. Lea
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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incision with absolute pre-cision. Most Suigeons prefer to relyon their own skill to accomplish this,and mechanical contrivances have verygenerally and perhaps somewhat un-justly been discarded. Of all tlieinstruments of the kind referred to,that which is the invention of N. R.Smith, of Baltimore, is tlie most in-genious and practically useful. This instrument consists of a staffwith appliances (Fig. t49), and a pecu-liarly shaped bent cutting gorget (Fig.150). It was first described and figuredby Smith in 1831. It has undergonemany modifications at the hands of itsinventor, and is now given to the pro-fession with all its improvements, asseen in Figs. 749 and 750. The staff consists of three parts. 1.A rectangular tubular staff, with a wideslit making a quarter turn, so as to fitit for lateral lithotomy. 2. Attached to the staff by a hinge close underthe handle, is an arm-piece, or conductor. This ends in a knife-blade, set at right angles to the shaft and deeply grooved at its under
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Fi . 749.—Smiths Lithotomy Staif aud Conductor. . 750 (to right).—Smiths Gorget. 1 AFTER-TREATMENT OF LITHOTOMY. 747 pnrt. 3. An indicntor consists of a slender rod traversing the handleof the staff and terminating in a cup sliding in the tubular staff. The mode of action of the instrument is as follows. The conductorbeing drawn back on its hinge, the rectangular staff is passed in theusual way into the bladder, the angle being brought just in front of theprostate and resting on the membranous part of the urethra. When theSurgeon has satisfied himself that the staff is in proper position, hedravvs down the conductor, and, pressing upon it, pushes its terminalknife through the tissues of the perineum until it enters the slit in thestaff. The groove in the conductor outside the peringeum is now con-tinuous with that in the staff which is in the urethra. The indicatoris now drawn up so that its cup lies immediately under the groove ofthe conductor. The superficial incision having bee

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