VOL. XLl.] PHILOSOPHICAL TRANSACTIONS. 5^7 



some time with good success ; but had the operators at that time had the benefit 

 of this instrument, Mr. C. is persuaded the advantage would have been more than 

 equal in favour of the high operation, and preferable to any other method yet 

 practised. And he hopes that the description, and the method of using 

 this catheter, will be a means of reviving an operation so happily begun, and 

 calculated for the good of those that are afflicted with the stone in the 

 bladder. 



This catheter is made either of silver or steel, of different sizes, to suit dif- 

 ferent ages ; and has the outward appearance of a common catheter, and will 

 answer the same uses. But in respect to this operation, it differs from the 

 common in this, that it is composed of two legs, with blunt points, a long 

 tube, a sliding bolt ; and a handle, which serves to open and shut the legs. 

 The bolt, which is fixed to the extremity of the tube, goes into two holes, 

 fixed in the plate of the handle : the one serves to keep the legs close during 

 the time it is to be introduced into the bladder, the other to extend the 

 points at the distance of an inch or more, during the time the operation is per- 

 forming. 



The method of using this catheter is, after having taken the necessary pre- 

 cautions, and filled the bladder, first to introduce the catheter into the bladder, 

 then unbolt it at the handle, and by holding the tube in one hand, and the 

 handle that moves the legs in the other, turn or open the legs, till the bolt 

 becomes opposite to the second hole on the plate, into which the bolt must be 

 thrust ; then by pressing gently the handle downwards between the patient's 

 legs, the 2 blunt points will be easily felt above the os pubis, in the protu- 

 berance made by the injection into the bladder. 



The advantages he proposes, by using this instrument, are these : First, to 

 be a director for the operator, in determining the place where the puncture is 

 to be made in the bladder. It also serves as a support to the bladder, when the 

 water flows out ; and keeps it from subsiding during the time of the operation, 

 and till the stone is extracted : it serves also to resist the pressure of the abdo- 

 minal muscles and peritoneum, and hinders the intestines from being forced 

 down upon the knife ; and keeps the orifice open, till the stone or stones are 

 brought away. And lastly, by the help of this instrument it may be disco- 

 vered, whether the bladder is indurated or scirrhus. 



The method of performing this operation with safety, is, after having intro- 

 duced and fixed the catheter with its legs open, to feel for the 2 points above 

 the OS pubis, and place the finger and thumb gently upon them ; then give the 

 handle to an assistant, to keep it firm in that position ; and with the knife in 

 the right hand, make a puncture at once into the bladder, exactly in the middle 



