fi28 DISEASES OF THE BLADDER, ETC. 



purpose very well ; they should, however, be provided with a 

 lolialcbone stillct, the wire ones usually provided being apt to 

 bend upon tlieinselves, and remain in the bent position when 

 the point of the catheter reaches the ischiatic arch. When the 

 insti-ument has reached the symphysis pubis, the stillet must be 

 withdrawn, in order to allow the catheter to pass easily along 

 the pelvic floor. 



The catheter having reached its destination, an incision is to 

 be made upon it, at the perineum, so as to freely expose the 

 interior of the urethra, and to bring the catheter fairly and 

 clearly into view. The catheter being withdrawn, the smaller 

 forceps is to be introduced into the ujethra, and by a gliding 

 motion pushed into the bladder. Some little diffic\ilty is 

 generally experienced in doing this, from the fact that the 

 sphincter vesica contracts pretty firmly upon the instrument ; 

 the operator must therefore exercise a little patience, or the 

 parts may be torn by a forcible introduction. 



Many writers describe lithotomy as a very complicated opera- 

 tion, and that it must be performed by various cuttings with, 

 long-bladed bistouries, guided by " directors," &c., and Professor 

 Dick used to say that it was necessary to take np the pudic 

 artery ; but none of these are requisite, one free incision, su£&- 

 ciently large to admit the forceps, is all that is required. I 

 have operated in this manner, both for the stone, and experi- 

 mentally, before my class repeatedly, and always successfvJly. 

 It is advisable that the forceps be warmed and dipped in oil 

 before it is introduced, as the sensation of cold causes the 

 sphincter of the bladder to coxitract with some force, and ita 

 introduction to be a matter of difficulty. 



The operation of cutting for the stone is called lithotomy; 

 that of crushing the stone without cutting, lithotripsy ; and that 

 of boring or rubbing the calculus, in order to reduce it to powder, 

 lithotrity. These two latter methods are inapplicable, except in 

 the mare ; but it may be necessary to crush the stone in the 

 horss before removal, and, in such a case, the operation would be 

 a combination of lithotomy and lithotripsy. 



Provided the stone cannot be grasped whilst the horse is upon 

 his side, he must be placed upon his back, care being always 

 taken that the hand in the rectum shall guide the stone into the 

 forceps. 



