UEETHKOTOMY. 



565 



suiting from some special trauma- 

 tism would be such a case ; or again, 

 when the formation of calcuH has 

 become an established constitutional 

 habit, and the results of this perver- 

 sion of the nutritive and assimilative 

 function are always present and con- 

 tinually renewed. In view of this 

 unfortunate state of things, and to 

 prevent the closing of the wound, 

 Troeber recommends the use of a 

 peculiar tube, which, when intro- 

 duced into the urethra can be per- 

 manently retained in place for an 

 indefinite length of time (Fig. 473). 

 We have attempted the formation 

 of an artificial urethral opening, by 

 sewing together the mucous mem- 

 brane of the canal and the skin, but the results of the experiment 

 were of the most transient character. 



Fig. 473.— Tube ol Troeber, for Ischial 

 Urethrotomy in Bovines. 



CYSTOTOMY. 



Improperly known also as lithotomy, is an operation which 

 consists in the incision of the neck of the bladder to remove cal- 

 culi of dimensions too great for removal intact through the 

 urethra. This operation has no longer a place in our surgery, 

 and, in fact, there is no existing reason for its performance. If a 

 calculus is of small or of medium size the neck of the bladder 

 can always be sufficiently dilated to permit its passage, and if it 

 should be of greater dimensions, and rendered impossible of ex- 

 traction by its size, the operation of lithotrity is always available, 

 and in experienced hands as nearly certain and safe as can reason- 

 ably be expected. 



LITHOTEITY. 



This term designates the operation of crushing, or piercing, 

 or driUing stones in the bladder, in order to reduce them to frag- 

 ments, preparatory to their removal by means of forceps or cur- 

 ates, or by washing them out of the bladder with water. It 

 mostly corresponds with, or rather, includes the hthotomy of 



