156 
MEMOIR ON VESICAL CALCULI, &C. 
of the left carried by the external wound through the urethra into 
the bladder, the stone u was guided to the neck of .the bladder, 
and then easily forced out through the opening in the urethra.” 
Mr. Percivall, in his u Lecture” on this subject (Part III, p.47), 
recommends to our notice a mode of proceeding which, though not 
novel in itself, is one which even yet, we believe, remains untried; 
and that is, the dilatation of the urethra. To quote Mr. P.’s own 
words — u Were I called to a case of this description, I should not 
proceed by ‘ cutting for the stoneI should give the decided pre¬ 
ference to the operation of dilatation,—one that, it strikes me, with 
an instrument properly constructed, is singularly applicable, not 
only in the female but in the male subject, to veterinary practice.” 
To proceed, however, with the operation by incision. M. Girard 
tells us 
“ That the cut through the pelvic portion of the urethra ought always to 
be made obliquely to one side; that the operator should hold his bistouri in „ 
that direction that its cutting edge be turned towards the angle of the thigh. 
By this procedure we shall gain easier access to the bladder, and not only 
avoid wounding the rectum, but also the artery of the bulb, as well as the 
bulb itself, and suspensary ligaments of the penis.’ 7 
The parts cut through in the operation are— 
“ 1st, The tine thin skin of the perineum, smooth externally, and marked 
with the raphe; densely cellular, internally. 
“ 2dly, Adhering to the skin, the faschial covering, derived from the 
faschia superficialis abdominis, which is here become fibrous: it forms the 
common envelope to the parts underneath, and is closely connected with 
the corpus musculosum urethrae. 
“ 3dly, The corpus musculosum urethrae — that penniform band of fleshy 
fibres which springs by two branches from the ischiatic tuberosities, em- , 
bracing the sphincter ani, and concealing the arteries of the bulb ; whence 
they unite, and proceed to envelope the urethra. 
“ 4thly, The corpus spongiosum urethrae , the part immediately covered i 
by the muscular envelope, and which here is bulbous. It is more particu¬ 
larly worthy our remark, from two arteries penetrating it, which come from 
without the pelvis, ascending obliquely outward to reach the bulb. 
“ 5thly, The suspensory ligaments of the penis, pursuing the course of, 
and adhering to, the tendinous union of the accelerators. 77 
An attention to the relative position of these parts will demon¬ 
strate the advantages of the lateral oblique incision over one made 
directly along the raphe: by pursuing the latter, we necessarily 
cut through the suspensory ligaments and into the bulb, wound¬ 
ing, thereby, the arteries; whereas, by the former, all this danger 
is avoided, besides that it renders the operation more simple and 
facile. 
[To be continued.] 
