OCR Text |
Show 38 or FORMING A new ciixAL, or FORMING A NEW CANAL. From a case of Mr. Lynn's, I have represented the appearance of the state of the wound when the bougies should be Withdrawn and the catheter introduced. But now, if the case the canula: now, taking this stilette and canula firmly in my 01‘ FORMING A NEW' URETHRA, WHEN PART OF THE CANAL HAS below the place where the urethra was deficient ; then taking A wasrixo ulcer, during a mercurial course, will sometimes mum rundown from the corona glandis, under the prepuce, and eating into the substance of the penis, not only lays open the urethra but altogether carries it away. A gentleman present- ed himself to me in this situation, having uniformly met with hand, I directed the sharp point obliquely from the proper course of. the canal into the body of the penis, and then carri~ ed my instrument behind the tract of the urethra, until I got the directory in my left hand, I made the sharp point of the stilette grate into the groove of the directory, and of course into the proper course of the urethra; then, holding the canula and directory very firmly, the sharp instrument was withdrawn from the canula, when the probe was again intre~ duced, and being pushed along the groove of the directory, the canula was fairly lodged in the lower part of the urethra. discouragement from several eminent surgeons, to whom he Through this canula the urine passed freely, not a drop cs had applied, they told him it was common but irremcdiable. caping by the former breach in the urethra ; and during the operation not a drop of blood passed ; my assistant expected some basons full. I considered three weeks necessary to con- He had two strictures at the same time, and the urine flowed <-,‘y~»u-.‘:d= flx‘fi-e‘. '40:)va which the urine was wont to flow, and pointed it downwards to the perineum, the groove of the instrument being towards the body of the penis. I now gave this directory to my assistant, and withdrawing the probe which was in the canula, I introduced my sharp stiletto, and pushed the point through be neglected, and the catheter allowed to hang, bearing down the penis, it will stretch the parts, so that the lips of the wound will contract behind the catheter, and the part becoming callous, the catheter will be left bare, and a cicatrix he formed behind it. BEEN DESTROYED BY ITLCER. \ .7... "1 y. 89 from the side of the penis. I engaged myself, in the first place, in destroying the strie tures, so that the canal might hear a silver canula lying in it. I then dilated the part of the canal towards the extremity of the perm, to see whether the urine would by this means leave the opening in the side, and take its proper channel ; but indeed this I could not expect, as the canal was actually deficient about an inch and a half. I was reduced to the necessity of performing the following operation. I had a silver tube made, six inches in length, and adapted to it arod of soft metal, which projected through it with a. probe point. I had also a very sharp stilette titted to it. solidate the new passage into a firm canal. The only diilicul- ty was in retaining the tube in its place, and keeping the e3:- tremity which was in the urethra from inflaming the canal. This I found could best be accomplished by introducing one of Mr. \Vhite's flexible metallic bougies, which, passing be yond the sharp edge of the tube, kept the urethra from press» ing upon it, and prevented the penis from bending at that part, A T bandage being brought round the perineum, and split, received the end of the bougie, and pressed in the silver tube, so that it could not escape by accident, or by the impulse of had likewise a directory of somewhat peculiar figure, to pass the urine. By wearing this tube for some time, and, afterwards; by the into the opening of the urethra in the lower part of the pCIIiF> ‘use of the common bougie, introduced into the new passagt‘, In the operation I introduced my canula and its probe pointed stilette down to near the place of opening in the ure I made a complete canal. But one circumstance has failed in, accomplishing a perfect cure. The gentleman can turn to titre. the wall, like his neighbrnuw, without the danger of spoiling I I then introduced the r-tirectory into the Opening from \m. ‘c MAI \Mnit‘h ,. 7.... AM)"; . | |