Identifier: operativesurgery02brya (find matches)
Title: Operative surgery
Year: 1899 (1890s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914
Subjects: Surgery, Operative Surgery, Operative
Publisher: New York : D. Appleton and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
ucous membrane be assured and that the fragments fallin a handy place for subsequent treatment with the least injury to the blad- ()ii:KATk)Ns ox Ilii: ri;i.\Ai;v i-.i.addkk. lir,3 (lor wall. If the stone be soft the jjixssure of u steady turn of the screw iseiillieient ; if hard, a quick vigorous turn nuiy be needed to crush it. Ineither instance, if quietly done, the fragments fall and lie close at hand, andcan be caught and crushed by repeated opening and closing of the bladeswith the same deliberate care and manipulation tiiat characterized the jjri-niary act. That is, the male blade should be withdrawn with the beak up-ward and axis of the instrument unchanged, then turned to the right orleft and carefully closed, when, if a fragment be caught, the beak is againturned upward, away from the wall, and the fragment crushed. During thecrushing the fi-male blade must be heUl lirmly and at an angle of 4.5° withthe horizon, and remain entirely passive (Fig. 1351), and the blades should
Text Appearing After Image:
Fu l:,:»l, iiiaiiiuT (if lidliliiiir the liilmirile when opening and shuttingin the search for fragments. only be separated sufficiently to admit the stone between them. If the beakbe not turned away from the stone before it is opened, the stone may be dis-placed by the separation of the blades. Each siffiitf/, if without an.esthesia, should not exceed five or ten minutes;with it, a sitting can be prolonged until an ordinary calculus is reduced tofragments, usually from ten to fifteen minutes. When the sitting is com-pleted the blades must be screwed firmly together, so that the instrumentmay be withdrawn without injury to the urethra. The intervals of the crush-ing will depend upon the size of the stone, its hardness, and more frequent- 1164 OPERATIVE SURGERY. ly upon the effect of tlie crushing upon the patient. Inasmuch as the con-ditions differ greatly, it is impossible to lay down any absolute rules. Thesurgeon should not repeat the operation until the subsidence of the irrita-t

Note About Images