366 



HEALTH AND DISEASE 



ARNOLD aSiNi LONDON 



upon the nature and extent of disease existing in the bladder. If there 

 is reason to think that the lining membrane is seriously ulcerated, or 

 covered with false membrane, a distinct advantage will be gained by 

 introducing a lithotomy tube (fig. 156) into the bladder and allowing 

 the wound to remain open until the vesical irritation has been subdued 



by frequent inj ections 

 of warm carbolized 

 water. On the other 

 hand, if no such com- 



Fig. 156. Drainage Tube plications exist there, 



A, Silver mount and rings. B, Elastic gum tube. the edges of the Super- 



ficial wound may be 



brought together at once by three interrupted sutures of flexible wire, 

 and the patient removed to his box. 



The irritation resulting from the operation naturally leads to much 

 whisking of the tail, during which hairs become entangled with the wire, 

 and the parts about the wound suffer considerable contusion; this must 

 be provided against by tying the tail on one side to a roller or some 



other convenient arrangement. 

 Under ordinary circum- 

 stances but little is needed in 

 the shape of after-treatment. 

 The skin below the perineum 



is smeared with lard or vaseline to prevent excoriation by the urinary and 

 other discharges, and the wound is carefully cleansed and carbolized as 

 often as may be required. An enema of warm water occasionally thrown 

 into the rectum affords a good deal of comfort by freeing the gut from 

 feculent matter, and removing all pressure from the sore and sensitive 

 urethra and bladder beneath. 



Lithotripsy. The operation of lithotripsy or crushing may be 

 resorted to when the stone, though too large to be moved entire, is yet 

 small enough to be seized and broken up into fragments by means of the 

 lithotrite. In the quadruped it is not performed as in man, through the 

 natural channel of the urethra, but through an artificial opening in the 

 urethral canal as described in the operation of lithotomy. It must, there- 

 fore, always be regarded as supplementary to lithotomy, and depend for 

 its performance on our inability to extract the calculus whole. 



In the absence of serious complications lithotripsy offers a fair and 

 reasonable prospect of success. 



If from the first the operation is found to be necessary, the bowels 

 should be freely opened with an aloetic purge, and the diet so ordered as 



Fig. 157.-Perineal Needle 



