| OCR Text |
Show 140 or HYDROCELIJ, The PALLIAIIVE case, as it is called, is the mere evacua- tion of the water of the hydroeele, by means of the trecar. But as the evacuation and suspension of the testicle is the whole of this operation, the description of it is of course in» cluded in the more perfect cure by injection. OF THE CURE BY IXJECTION. AKD Inn emu: BY INJECTION. 14d pose the tunica vaginalis; and then to introduce the trocar and canula. If there be difficulty in the case; if the state of the testicle be suspicious ; if the. hydrocele be complicated with hernia-- then we should cut the scrotum with the point of a laneet, and puncture the sac, introducing a common probe, to facilitate the escape of the fluid, and enable us to examine the testicle by the touch. THE intention of this operation is to excite such a degree of inflammation in the surface of the tunica albuginea, and tunica vaginalis, that being left in contact by the evacuation of the fluid, they may adhere and preclude the possibility of all future exudations. INSTRUMENTS. THE apparatus for injecting the hydrocele are, a lancet and probe. \t inc and warm water, mixed; three parts of wine to one of water. I have only to notice, that I have found the common bladder preferable to the elastic bag, as much less apt to inject air instead of the fluid. OPERATION. The patient should be placed. on the side of the bed, with his hips and back so supported that. any involuntary start may not have the eit'ect oi makin;r him shrink from the pumture. Or let him be placed on a chair, and by pillows be pre- x ented from retreating with a sudden jerk, which may cause the instrument to slip out after puncturing the sac, and oblige the surgeon to defer the latter part of the operation. If the tumour be equable and smooth, and the scrotum and (oats of the testicle thin, and the nature of the case quite de- cided, we at once introduce the troear. If the integumcnts are strong and thick, and the tumour small, I would advise the surgeon to puncture the scrotum, or rather to make a small incision into it with the point of a laneet, in order to c1 In making the puncture, the whole scrotum should be grasped in the hand, and the fore-finger and thumb brought round in such a manner as to grasp the neck or upper part: of the tumour, fig. 1. The lower part is in this way more distended, and the fore-part of the sac removed from the surface of the testicle. You now introduce the trocar and canula (but without plunging it) into the inferior and fore-part of the tumour. This plan, fig. 2, however, will show that we must not pierce directly inward -, but having entered the sac, carry the FIG. 2. |
