Die Behandlung der Schusswunden des Kniegelenks im Kriege / von Ernst Bergmann.

  • Bergmann, Ernst von, 1836-1907.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Die Behandlung der Schusswunden des Kniegelenks im Kriege / von Ernst Bergmann. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    triangulär ligament. The first part of this rule applies also to the introcluction of a lithotrite, and even a curved catheter. A free injection of oil is important. 8. A small meatus should be enlarged, or a stricture divulsed, to allow the passage of a large tube. 9. If the bladder be not small, a large and powerful lithotrite is always better than a small one. 10. That this may have room for action, the escap- ing water should be replaced occasionally, through a tube inserted a few inches into the urethra by the side of the lithotrite. But the bladder should not be over- distended. 11. To save time, and also to prevent undue dila- tation of the vesical neck, a non-impacting lithotrite is desirable. The jaws of a non-fenestrated instrument will not impact, if the male blade is furnished with alternate triangulär notches by which the debris is discharged laterally, and also with a long thin spur at the heel fitted to a corresponding slot in the female blade, — provided the floor of the female blade, especially at the heel, be made nearly on a level with its rim. To repel the blad- der, the female blade should be longer and a little wider than is usual. It should have also low sides easily ac- cessible to fragments, — relying for strength less upon these than upon a central ridge below the heel. In the male blade of such a lithotrite the apices of the triangles should be a little blunted. Lastly, a non-fenestrated female blade protects the floor of the bladder, during a long sitting. A fenestrated instrument directs sharp Splinters against it. The latter also delays the process of disintegration, by delivering through its opening the same fragments many times. 12. In locking and unlocking a lithotrite repeatedly in a long Operation, it takes less time and is easier to