The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. LVII. How to take stones out of women's bladders.

WE know by the same signs that the stone is in a woman's bladder as wee do in a man's, yet it is far more easily searched by a Catheter,* 1.1 for that the neck of the blad∣der is the shorter, broader and the more straight. Wherefore it may not onely bee found by a Catheter put into the bladder, but also by the fingers thrust into the neck of the womb, turning them up towards the inner side of the Os pubis, and placeing the sick woman in the same posture as wee mentioned in the cure of men. Yet you must observ that maids yonger then seven yeers old, that are troubled with the stone, cannot bee sear∣ched by the neck of the womb, without great violence. Therefore the stone must bee drawn from them by the same means as from boies, to wit, by thrusting the fingers into the funda∣ment; for thus the stone beeing found out, and the lower bellie also pressed with the other hand it must bee brought to the neck of the bladder, and then drawn forth by the foremen∣tioned means. Yet if the riper yeers of the patient permit it to bee don without violence, the whole work shall bee more easily and happily performed, by putting the fingers into the neck of the womb, for that the bladder is nearer the neck of the womb, than it is to the right gut. Wherefore the fingers thus thrust in, a Catheter shall bee presently put into the neck of the bladder: This Catheter must bee hollow, or slit on the outside like those before de∣scribed but not crooked, but straight, as you may perceiv by the following figure.

[illustration]

A Catheter, upon which, being put into the bladder, the neck thereof may bee cut to draw out a stone from a woman.

Upon this instrument the neck of the bladder may bee cut, and then with the Dilater made for the same purpose, the incision shall bee dilated as much as need require's; yet with this caution, that seeing the neck of a womans bladder is the shorter, it admit's not so great dilation as a mans, for otherwise there is danger that it may com to the bodie of the bladder, whence an involuntarie shedding of the water may ensue and continue thereafter. The incision beeing dilated, the Surgeon putting one or two of his fingers into the neck of the womb, shall press the bottom of the bladder, and then thrust his crooked instruments or forcipes in by the wound, and with these hee shall easily pluck out the stone, which hee shall keep with his fingers from slipping back again. Yet Laurence Collo the King's Surgeon, and both his sons (than whom I do not know whether ever there were better cutters for the stone) do otherwise perform this operation; for they do not thrust their fingers into the fundament or neck of the womb, but contenting themselvs with putting in onely the guid∣ers (whereof wee formerly made mention) into the passage of the urine, they presently thereupon make straight incision directly at the mouth of the neck of the bladder, and not on the side as is usually don in men. Then they gently by the same way thrust the forcipes hollowed on the out-side formerly delineated, and so dilate the wound by tearing it as much as shall bee sufficient for the drawing of the stone forth of the bladder. The residue of the cure is the same with that formerly mentioned in men: yet this is to bee added, that i•• an ulcer grow in the neck of the bladder by reason of the rending it, you may by putting in the speculum matricis, dilate the neck of the womb, that fitting remedies may bee applied with the more eas.

Notes

• * 1.1

  How to search for the stone in women.