Part 41 (2/2)

Fig. 5, Plate 59.--The stricture a appears midway between the bulb and glans, the area of the pa.s.sage through the stricture being sufficient only to admit a bristle to pa.s.s. It would seem almost impossible to pa.s.s a catheter through a stricture so close as this, unless by a laceration of the part, combined with dilatation.

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Plate 59.--Figure 5.

Fig. 6, Plate 59.--Two instruments, a, b, have made false pa.s.sages beneath the mucous membrane, in a case where no stricture at all existed. The resistance which the instruments encountered in pa.s.sing out of the ca.n.a.l having been mistaken, no doubt, for that of pa.s.sing through a close stricture.

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Plate 59.--Figure 6.

Fig. 7, Plate 59.--A bougie, b b, is seen to perforate the urethra anterior to the stricture c, situated an inch behind the glans, and after traversing the substance of the right corpus cavernosum d, for its whole length, re-enters the neck of the bladder through the body of the prostate.

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Plate 59.--Figure 7.

Fig. 8, Plate 59.--A bougie, c c, appears tearing and pa.s.sing beneath the lining membrane, d d, of the prostatic urethra. It is remarked that the origin of a false pa.s.sage is in general anterior to the stricture.

It may, however, occur at any part of the ca.n.a.l in which no stricture exists, if the hand that impels the instrument be not guided by a true knowledge of the form of the urethra; and perhaps the accident happening from this cause is the more general rule of the two.

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Plate 59.--Figure 8.

Fig. 9, Plate 59.--Two strictures are represented here, the one, e, close to the bulb d, the other, f, an inch anterior to this part. In the prostate, a b, are seen irregularly shaped abscess pits, communicating with each other, and projecting upwards the floor of this body to such a degree, that the prostatic ca.n.a.l appears nearly obliterated.

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Plate 59.--Figure 9.

Fig. 10, Plate 59.--Two bougies, d e, are seen to enter the upper wall of the urethra, c, anterior to the prostate, a b. This accident happens when the handle of a rigid instrument is depressed too soon, with the object of raising its point over the enlarged third lobe of the prostate.

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Plate 59.--Figure 10.

Fig. 11, Plate 59.--Two instruments appear transfixing the prostate, of which body the three lobes, a, b, c, are much enlarged. The instrument d perforates the third lobe, a; while the instrument e penetrates the right lobe, c, and the third lobe, a. This accident occurs when instruments not possessing the proper prostatic bend are forcibly pushed forwards against the resistance at the neck of the bladder.

[Ill.u.s.tration]

Plate 59.--Figure 11.

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