Demonstrations ON THE CYSTOSCOPE: AND A METHOD OF ILLUSTRATING DISEASES OF THE BLADDER AND THE APPEARANCES IN RENAL DISEASE BY THE OPAQUE PROJECTOR
Authors: D. Newman
Journal: BMJ (1906)

GENTLEMEN,-IIi the name of my colleagues and on my 'own belhalf I welconie you very cordially to joinl us in our euideavour to establish post-graduate medical classes in this city.The very large, practically unlimited clinical ;tnaterial at your disposal affords abundant opportunities 'of studying disease in all its plhases, and it wvill be our -object to present it to you by demonstrationis in as practical a form as possible.The medical and surgical staff of the lhospital, with thle lhearty co-operation of the maniagers, lhave arraniged thlree terms, onle during February and Marchl, the second iii May and June, and the third durilig October and November.We recognize that success depends upon ourselves.This demonstrationi is the first of the winter term, and the series includes in all seventy-five meetinigs, details -of which you will find in the syllabus.The subject I liave selected is surgical diseases of the uriniary organs, anid I intenid to make the teachlinig as far as possible practical an-d clinical.In studyinig diseases of tlle bladder and kidneys, it is very necessary in-the first place to kniow the tecllhiique of tlhe mloderni cystoscope, and in tlle second place to become familiar witlh the appearanices preselnted by it to our view.'Thie foriiier is quickly anld easily acquired, the latter in all its details deman-ds many years' experience.In relationship to diseases of the kidney, examiniation -of the bladder with the cystoscope hias proved of great j)ractical value, not only in a niegative way by eliminiating lesions of the bladder from the diagnosis, but also by ggiving positive evidence of tlle preseniee of disease in one 'or both kidnieys.Whiemi iieplireetomy is contemplated on Vone kidney, a knowledge of the presence and functional activity of the other is of primary importance.From 'ocular inspection, if carefully carried out by an educated eye, exact conclusions may be drawni wlhicll cannot be arrived at by other means, anid the course of treatmen-t can be decided upoIl early in the course of the disease.By so employing this method, most valuable time may be utilized which would otherwise be wasted waiting for 'other evidence to prove the n-ature of the renal lesion.Too often, wheni we wait unitil the symptoms are :sufficiently significant to form a basis for diagnosis, the disease has advanced beyond our power to remedy.Cystoscopy, wlhein conducted with aseptic precautions, is unattended with danger, and is comparatively easily carried out in both sexes, but for obvious reasons witl greater facility in the female.After over twenty years' work witlh the electric cysto--scope in its various forms, I feel that I have much still to learn.It must be admitted that while in manly instances the cystoscope is not a difficult instruinent to use, in 'othlers the greatest cautioii and care is required in order to accurately appreciate' what is seen.This I will fully explain later on.It may, however, be encouraging to you to know that althougl miecessarily self-taught, I found that in my early experience many of the grosser lesions of the bladder were easily recognized at first sight, and doubtless in using the instrument you will have the same experience, but with the advantage that you will have some initiation to the work.As in disease of other organs so