368 
A CASE OF LITHOTOMY. 
After casting the animal with side lines, and properly securing • 
his hind legs by a piece of web passed under his back, so as to 
keep his hocks well apart, he v\ as lifted upon an operating table 
about two feet and a half high, and properly supported on his 
back with straw under and on each side. The rectum was then 
emptied with the hand, and the bladder slightly distended by in- 
jecting half a pint of tepid sweet oil along the urethra, the orifice 
of which was secured by the hand of an assistant. A slightly 
double curved staff, about twenty inches long, was then intro- 
duced along the urethra, and carefully carried into the perineum, 
as far as the angle of the canal would permit. 
With a stout common scalpel I then made an incision through 
the integuments along the left side of the perineum, commencing 
about two inches in front of the verge of the anus, and extending 
downward and outward along the base of the ischio-rectal fossa. 
This incision extended only through the skin, the superficial pe- 
rineal fascia, and, at the anterior part, a few of the fibres of the 
retractor muscle of the sheath. 
The second step in the operation consisted in securing the in- 
ternal pubic artery, which, from its large size and superficial 
course at this part, I considered in danger of being wounded 
either in its trunk or primary branches, which would have im- 
peded considerably the subsequent part of the operation. For 
the purpose of obviating all these, I considered it most advisable 
to secure the common trunk before it gives off any of its branches 
to the rectum or perineum. This I succeeded in doing by mak- 
ing a dissection along the inside of the tuberosity of the ischium 
at the posterior part of the wound : I thus cut at once into the 
urethra upon the point of the staff, which immediately protruded 
into the wound, and from which the contents of the bladder be- 
gan to escape. I then put my finger on the point of the staff, 
and pushed it backwards, which introduced my finger into the 
urethra, where it was retained ; and, the staff withdrawn, with the 
fore and middle fingers of my right hand, I then separated the 
parts about the neck of the bladder from the rectum and side of 
the pelvis as far as I considered necessary. A straight grooved 
staff was next passed, by means of my finger, which I had retained 
in the urethra, into this canal, and carried onwards to the blad- 
der, on entering which it at once struck against the stone, pro- 
ducing a clear metallic sound, 
I then passed along the groove on the staff a curved probe- 
pointed bistoury, with the cutting edge on its convex side, simi- 
lar to Sir W. Blizard’s lithotomy knife. With this I divided the 
remaining portion of the urethra and the neck of the bladder, cut- 
ting both in passing it inwards, and, when withdrawing it in the 
