STONE IN THE URETHRA. S79 



longitudinal incision must then be made, six inches in length, through 

 the sheath, upon the penis, and in the direction in which it lies. The 

 penis being exposed, it is seized and drawn forward in its sheath ; the 

 muscles relax, the penis is readily brought into a straight direction, 

 and held so for a sufficient time to admit the introduction of a stilett, 

 which should either be composed of whalebone, and very flexible, or 

 it should be made of iron, and jointed. The more flexible the cathe- 

 ter is, the more readily it will accommodate itself to the tendeney of 

 the muscles to restore the inverted S curve, and the more readily 

 likewise may it be bent round the bony arch beyond, and so diminish 

 the length of the incision which must afterwards be made between 

 the anus and the scrotum. 



The sound being passed through the curvature thus temporarily re- 

 moved, and its point felt below the anus, the operator must cut into the 

 urethra at that part. Into this opening he must inti oduce another 

 rod, straight and grooved, and pass it on into the bladder ; and then, 

 by means of a probe-pointed bistoury running in this groove, the 

 incision must be carried on to the side of the anus, and through a 

 portion of the neck of the bladder corresponding with the supposed 

 size of the calculus. The operator must then pass his right hand 

 into the rectum, and the two first fingers of the left hand into the 

 bladder, and with the right hand guide the calculus between the 

 fingers of the left hand, by which, or by means of a pair of forceps 

 pushed into the wound, it should be seized and extracted. 



It is not always that there Avill be much bleeding, or that it will be 

 necessary to take up any of the vessels, or even to pass any sutures 

 throus^h the edc^es of the wound, unless the incision has been more 

 than usually large. The urine will for a few days be principally 

 passed through the wound, but a portion of it will soon begin to find 

 its ways through the urethra, and that quantity will daily increase, and, 

 in quite as short a time as can be expected, the wound will be per- 

 fectly healed. 



STONE IN THE URETHRA. 



On account of tl^ length, and narrowness, and curvature of the 

 urethra in the ox, obstruction of that passage by a calculus is a cir- 

 cumstance of too frequent occurrence. The symptom which would 

 lead to a suspicion of this, would be, in addition to the evidence of 

 considerable pain and general irritation, a complete, or almost com- 

 plete, suppression of urine. The practitioner should examine tlie 

 urethra through the whole of its course anterior to the inverted S 

 curve ; the calculus will tlien be felt, or probably the protuberance 

 caused by its presence will be immediately seen. The duty of the 

 surgeon is now, in most cases, easily and quickly perfoimed. An 

 oblique incision must be made upon the calculus, sufficiently long to 

 enable it to be taken out. By means of the oblique incision, the 



