A DICTIONARY. 



267 



parietes of the part of the rectum adherent 

 to it, by means of a straight bistoury, is 

 easily practised ; but in its consequences is 

 dangerous in the extreme : in fact, it is an 

 operation never to be adopted but in a case 

 where the magnitude of the stone precludes 

 its extraction through the neck of the blad- 

 der. In all other cases, lithotomy by the 

 urethra is to be pursued. For its perfor- 

 mance, are required a straight probe-pointed 

 bistoury, a whalebone fluted staff, and a 

 pair of forceps curved at the extremities. 

 The animal should, if practicable, be main- 

 tained in the erect posture. The tail plaited 

 and carried round on the right quarter, the 

 operator feels for the end of the staff intro- 

 duced up the urethra, and makes an incision 

 directly upon it, from above downwards, an 

 inch and a half or two inches in length. 

 Next, he introduces the sound, and passes 

 it onward into the bladder. Now, placing 

 the back of the bistoury within the groove 

 of the sound, by gliding the knife forwards, 

 the pelvic portion of the urethra, and also 

 the neck of the bladder, become slit open ; 

 the latter in two places, in consequence of 

 a second cut being made in withdrawing 

 the bistoury. The opening made being 

 considered of sufficient dimensions, the oper- 

 ator introduces the forceps into the bladder, 

 and seizes the calculus, one hand being up 

 the rectum, to aid him in so doing. The 

 forceps clasping the stone are now to be 

 withdrawn, but with gentleness ; and with a 

 vacillating sort of movement of the hand 

 from side to side, in order more easily to 

 surmount any difficulties in the passage, and 

 the more effectually to avoid contusion or 

 laceration. M. Girard tells us, ' That the cut 

 through the pelvic portion of the urethra 

 ought always to be made obliquely to one 

 side ; the operator should hold his bistoury 

 in such a direction that its cutting edge be 

 turned toward the angle of the thigh. By 

 this procedure we shall gain easier access to 

 the bladder ; and not only avoid wounding 

 the rectum, but also the artery of the bulb, 

 as well as the bulb itself, and suspensory 

 ligaments of the penis.' The parts cut 

 through in the operation are, 1st, the fine 



thin skin of the perineum, smooth externally 

 and marked with a raphe ; densely cellular 

 internally : 2ndly, adhering to the tissue, 

 the faschial coverings derived from the fas- 

 chia superficialis abdominis, which has here 

 become fibrous : it forms the common en- 

 velope to the parts underneath, and is closely 

 connected with the corpus musculosum ure- 

 thrse : Srdly, the corpus musculosum urethrcB, 

 that penniform band of fleshy fibres wliich 

 springs by two branches from the ischiatic 

 tuberosities embracing the sphincter ani, and 

 concealing the arteries of the bulb ; whence 

 they unite, and proceed to envelop the 

 urethra: 4thly, the corpus spongiosum ure- 

 thr(B, the part immediately covered by the 

 muscular envelope, and which here is bulb- 

 ous. It is more particularly worthy our 

 remark, from two arteries penetrating the 

 bulb, which come from without the pelvis, 

 ascending obliquely outward to reach the 

 part : 5thly, the suspensory ligaments of the 

 penis, pursuing the course of, and adhering 

 to, the tendinous union of the erectores. 

 An attention to the relative position of these 

 parts will demonstrate the advantages of 

 the lateral oblique incision over one made 

 directly along the raphe : by pursuing the 

 latter, we necessarily cut through the sus- 

 pensory ligaments and into the bulb, wound- 

 ing thereby the arteries; whereas, by the 

 former, all this danger is avoided, besides 

 that it renders the operation more simple 

 and facile. 



" Tracheotomy. — Cases occur when this 

 operation is required ; as in strangles, when 

 the tumors threaten suffocation, or when 

 any substance has remained unswallowed 

 in the oesophagus, the pressure of which ob- 

 structs respiration. In a distressing case of 

 gunpowder bursting immediately under a 

 horse's nose, the effects of which tumefied 

 his mouth and nostrils, so as to prevent free 

 inspiration, the animal owed his life en- 

 tirely to our excising a portion from the 

 tracheal rings, about ten inches below the 

 angle of the throat. The operation is a very 

 simple one, and may consist either in a 

 longtitudinal section made through two or 

 three of the rings, or a portion, occupying 



