The first lines of the practice of surgery Volume 2; designed as an introduction for students and a concise book of reference for practitioners - Softcover
Synopsis
This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1820 Excerpt: ...anatomical demonstration of muscular fibres around this passage, and the effects which the action of the muscles in the perineum have upon the urethra, and certain strictures of it, I confess, that my own mind still inclines to the sentiment espoused by Haller, Hunter, and Sir E. Home, that the membrane of the urethra is itself contractile. Without this belief, it appears to me impossible, satisfactorily to account for particular phenomena, which are remarked in the functions of the urinary organs, and in the practice of surgery. Certainly every thing cannot be explained by the contraction of the larger muscles, with which the urethra is embraced. Thus, for instance, a bougie may frequently be easily introduced as far as a stricture; the patient suffers little uneasiness, and no resistance is experienced; but no sooner is the passage irritated by the pressure of the bougie against the obstruction, than it contracts, and grasps the instrument with manifest force. Much resistance is now felt on withdrawing the bougie, and it is in a great measure continued till the instrument is quite out of the urethra. There are few surgeons of any experience who have not observed this fact. Did the resistance depend upon a 'spasm of the muscles in the perineum, it could only last while the bougie was in the contiguous part of the urethra. We find, however, that even the last inch of the bougie is evidently grasped. The experiments of Haller are also at variance with the conclusions above related; for he distinctly mentions, that chemical stimulants will make the urethra contract. Indeed, as a late writer observes, the muscular power of this canal may be proved, almost in any instance, by introducing a bougie of moderate size into the healthy urethra, and lightly supporting...
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