Practical Lithotomy and Lithotrity, Or, an Inquiry Into the Best Modes of Removing Stone from the Bladder (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1863 Excerpt: ... in his Fig. 58. The first or ordinary position. Common screw Lithotrite, with a stone rather above middie size. movements. It should be at least thirty inches high; firm and steady. A bed may be used, provided the patient is placed on a mattrass, so that the pelvis does not sink, a position fatal to good practice; he must be brought with his right side close to its edge; but a couch or table about two feet wide is better, as admitting free access to either side. The pelvis is to be placed just above the plane of the shoulders, which must remain on a level with the rest THE EXCEPTIONAL POSITION. 161 of the trunk, the head only being raised on a pillow: this constitutes the ordinary position. A firm cushion, about two inches thick, should support the pelvis; an excellent substitute, to be found in any bedroom, is a common pillow rolled up tightly in a towel, which is then fastened by pins. The thighs are to be separated a little, so that there is a clear interval of about twelve inches between the knees, and each knee may be slightly raised on a small pillow, leaving the space between the legs clear for the operator. In this position the stone generally lies a little behind the neck of the bladder, and may be easily found and acted on by the lithotrite, provided the bladder and prostate are normal. In the exceptional position, the pelvis is raised from four to six inches above the level of the shoulders; a firm cushion of sufficient thickness is placed beneath the pelvis, so as to support the sacrum and tubera ischii. The thighs are slightly raised; they must not incline from the pubes downwards, or the position of the pelvis will be interfered with. The abdomen, on the contrary, inclines backwards from the pubic symphysis. The stone now lies on the posterio...