The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatusHill, Berkeley
Science
The essentials of bandaging: $b including the management of fractures and dislocations, with directions for using other surgical apparatus
Hill, Berkeley
Bandages and bandaging; Dislocations -- Treatment; Fractures -- Treatment; Surgery, Minor
Rigid instruments have one advantage over flexible ones, in that
their points can be guided by the surgeon; the points of flexible
instruments cannot be directed, hence the introduction of the latter
into a stricture is less easily managed, consequently bougies with
various kinds of points should be kept. But flexible instruments
cause far less irritation than rigid ones, and should always be
employed instead of the latter when possible: with patience and
practice much of the difficulty attending their introduction is
overcome. The French bougies, with tapering ends and bulbous points,
slip more easily through a stricture than instruments having the
same diameter throughout, and bougies with fine tapering points can
sometimes be introduced where others fail.
_Passing Catheters._—In passing instruments along the urethra the
conformation of its interior should be borne in mind. From the
meatus to the triangular ligament, the normal urethra, when gently
stretched, becomes a straight tube; having, nevertheless, just within
the meatus, a pouch in the roof, the lacuna magna, where the point of
the instrument may catch if not turned downwards. At the bulbous part
the urethra enlarges in capacity by having a slight downward curve in
its floor, just before the triangular ligament is reached. In this
depression, the beak of the catheter is apt to sink below the level
of the passage through the ligament, which is always a fixed point.
Beyond the triangular ligament the urethra curves gently upwards,
has a floor beset with irregularities, in which the point of the
instrument easily catches, if not raised as it passes along the curve.
Public-domain text, read in full here on John Shaqi.
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