Publisher's Synopsis
Excerpt from A Simplified Evacuator for the Removal of Débris From the Bladder After Lithotrity: Read Before the New York Academy of Medicine, November 1, 1883
The difference of even 2 or 3 mm. In the size of an evacuating tube, when below 30 mm. In circumference, makes an astonishing dif ference in its evacuating capacity. For instance, in using the evacu ating tube 30 mm. In circumference, twenty pressures of the bulb, of my new evacuator (fig. 12, page 18) at intervals of one and a half second, withdrew from the glass bottle (representing the bladder) and deposited in the receiver, 300 grains of crushed coral, which is almost identical in weight and mode of cleavage with mixed calculi. Whereas, under the same circumstances, with the same number of pres sures of the bulb, and in exactly the same time, with an evacuating tube of 27 mm. Circumference only 180 grains were deposited in the receiver. It may, I think, be confidently stated that in the absence of stricture, or congenital contraction of the meatus, or of prostatic en largement, an evacuating tube, two or three sizes smaller than the 1101. Mal urethra, according to estimate previously stated, may, as a rule, be easily and safely used.
Professor Bigelow uses, and recommends, the straight evacuating tube, in-preference to the curved. The calculous debris finds its way through it, much more directly and easily, and while less liable to be come clogged, it is more readily cleared. The only objection appears to be, the somewhat greater difficulty of introducing it into the blad der, especially in cases of enlargement of the prostate. I have modi fied the straight instrument of Professor Bigelow, by adding a small curved projection, which, with all the advantages of the former, I have found more easy of introduction, and preventing, in greater degree, the closure of the opening In the tube, from engagement of mucous membrane in it, during the process of evacuation. (see evacuating tubes in Fig.
Notwithstanding the statement of Professor Bigelow, already quoted, to the contrary, something more tlzan a large evacuating tube was essential to the new operation. This was a more powerful evacuating apparatus than that of either Clover or Mercier. This lack was supplied by Professer Bigelow - thus finally enabling him to perfect his operation of rapid lithotrity wit/i evacuation.
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