File:The surgical diseases of the genito-urinary organs including syphilis (1889) (14780960372).jpg

Identifier: surgicaldiseases00keye (find matches)
Title: The surgical diseases of the genito-urinary organs including syphilis
Year: 1889 (1880s)
Authors: Keyes, E. L. (Edward Lawrence), 1843-1924
Subjects: Urology Syphilis
Publisher: New York : D. Appleton and Company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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cter ofthe stricture may, occasionally, in the judgment of the operator, some-times require force, but the motive for its use must never be haste, ordesire to effect a rapid cure. The weight of the instrument, aided bya little coaxing, will usually exert all the power necessary. Festinalente is the golden rule. Patience and gentleness will effect morethan force in the long run. 118 STRICTURE OF THE URETHRA. THOMPSONS RAPID DILATOR. This instrument which Thompson devised for rapid dihitation—hisexpressed object being to stretch as much and tear as little as possible—still has a useful place among the instruments for the treatment ofstricture. Its inventor has practically discarded it in favor of the ure-throtome. In this country it is still used as a dilator, and as a divul-sor (to stretch a strictured point so as to tear it) in appropriate cases.The American instrument is modified by being tunneled, and is madestronger and to open more widely than the original instrument (Fig.40).
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Fig. 40. In using it, the slender (size 12) shaft is passed so that its point ofgreatest dilatability is placed in the strictured area. This is easilyaccomplished by first locating the stricture with a bulbous sound, andthen introducing the divulsor until the inch-marks upon the shaft in-dicate that it has reached the proper depth. Now, by turning thescrew-head in the handle, the blades are made to separate laterally toan extent indicated by markings upon the slot in the handle. When it is used upon a deep stricture, as the blades are being againapproached after the divulsion has been accomplished, a bit of mucousmembrane is liable to be caught in the angle of the blades, near thetip of the instrument. This is to be avoided by slowly pressing thetip of the instrument forward into the bladder as the blades are beingapproached. Divulsion, or tearing the stricture, is a rough manoeuvre, and hasof late years lost favor among surgeons. I formerly thought better ofit than now, and at the pr

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