Identifier: principlespracti1848drui (find matches)
Title: The principles and practice of modern surgery
Year: 1848 (1840s)
Authors: Druitt, Robert, 1814-1883 Sargent, F. W. (Fitzwilliam), 1820-1889. ed
Subjects: Surgery General Surgery
Publisher: Philadelphia : Lea and Blanchard
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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leftfore-finger well oiled into the rectum, to ascertain the size of the prostate,and its depth from the surface ; he should also explore with his fingersthe surface of the perinaeum, and the position of the rami and tuberositiesof the ischia. Everything being now prepared,—an assistant on each side holding thethighs firmly asunder—another being at hand to give the surgeon his in-struments—and a third stationed on the left side holding the staff perpen-dicularly, and well hooked against the symphysis pubis—-in which positionhe is to hold it steadily from first to last; — the surgeon commences bypassing in his knife to the depth of an inch on the left side of the raphe,about an inch before the anus, and cuts downwards and outwards to the LATERAL OPERATION. 491 bottom of the perinseum, midway between the anus and tuberosity of theischium. The forefinger of the left hand, says Mr. Liston, is thenplaced in the bottom of the wound about its middle, and directed upwards Fis. 157.
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and forwards ; any fibres of the transverse muscle, or of the levator of theanus, that offer resistance, are divided by the knife, its edge turned down-ward : — the finger passes readily through the loose cellular tissue, but isresisted by the deep fascia, immediately anterior to which, the groove ofthe staff can be felt not thickly covered. The point of the instrument isslipped along the nail of the finger, and, guided by it, is entered, the backstill directed upwards, into the groove, at this point. The finger all alongis placed so as to depress and protect as much as possible the coats of therectum, and the same knife, pushed forwards, is made to divide the deepfascia, the muscular fibres within its layers, and to perforate the urethraabout two lines in front of the prostate. Then it must be pushed gentlyinto the bladder, slitting up the urethra and notching the margin of theprostate in its course. The knife being withdrawn, the left forefinger isgently insinuated into the bladde

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