Surgical Instruments in Greek and Roman TimesMilne, John Stewart
History
Surgical Instruments in Greek and Roman Times
Milne, John Stewart
Surgery -- History; Surgical instruments and apparatus
'Wherefore taking a catheter proportionate to the age and sex we
prepare the instrument for use. The mode of preparation is this:
having bound a little wool round with a thread and introduced the
thread by means of a sharp rush into the pipe of the catheter, and
having cut off the projecting parts of the wool with a pair of
scissors, we put the catheter into oil. Having then placed the patient
on a convenient seat and used fomentation, if there be no
contra-indication we take the catheter and introduce it direct down to
the base of the penis, then we must draw the penis up to the umbilicus
(for at this part there is a bend in the passage), and in this
position push the instrument onwards. When in the perinaeum it
approaches the anus we must bend the penis with the instrument in it
down to its natural position, for from the perinaeum to the bladder
the passage is upwards, and we must push the instrument onwards till
we reach the cavity of the bladder. We afterwards take out the thread
fastened into the opening of the catheter, in order that the urine,
being attracted by the wool, may follow as happens in syphons.'
It is occasionally, in cases of cancer of the prostate, of service to
adopt this proceeding to prevent the eye of the catheter from getting
blocked before the bladder is entered, but it is strange that Galen should
have fallen into the mistake of thinking that it is necessary to set up a
syphon action, as he was well aware of the expulsive power possessed by
the bladder; in fact, his explanation of the physiology of urination is
almost up to date.
Celsus gives a good description of the catheter both male and female (VII.
xxvi):
Res vero interdum cogit emoliri manu urinam, quum illa non redditur,
aut quia senectute iter eius collapsum est, aut quia calculus vel
concretum aliquid ex sanguine intus se opposuit: ac mediocris quoque
inflammatio saepe eam reddi naturaliter prohibet. Idque non in viris
tantummodo, sed in feminis quoque interdum necessarium est. Ergo
aeneae fistulae fiunt; quae ut omni corpori ampliori minorique
sufficiant, ad mares tres, ad feminas duae medico habendae sunt; ex
virilibus maxima decem et quinque digitorum, media duodecim, minima
novem, ex muliebribus maior novem, minor sex. Incurvas vero esse eas
paulum, sed magis viriles, oportet, laevesque admodum; ac neque nimis
plenas neque nimis tenues.
Public-domain text, read in full here on John Shaqi.
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