On a mode of after-treatment in operations upon the urinary organs : with illustrative cases / by T.R. Jessop.

  • Jessop, Thomas Richard, 1837-1903.
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: On a mode of after-treatment in operations upon the urinary organs : with illustrative cases / by T.R. Jessop. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    and her bed had been constantly soaked with foetid urine. I found the bladder distended so as to reach above the umbilicus, the vagina in a putrid and sloughing state, and urine dribbling from the orifice of the urethra. A very large quantity of decomposed urine was at once drawn off through a catheter, which, with India-rubber tube attached, was fixed in the bladder. The friends were directed to syringe the vagina several times daily Mrith warm water. The catheter was removed at the end of six day.s, having during the whole of that time been the means of keeping the bladder continually empty, and the bed perfectly dry. The patient ultimately recovered witb no other defect than a contracted vagina. I might cite many other cases; but these are sufficient, I think, to prove that it is quite possible, by the means I have indicated, to carry off all the urine as secreted both from the male and female bladder, without allowing any to escape by the side of the instrument; indeed, whilst I have in dozens of instances proved the fact, I have not yet met with a case in which urine escaped by the side of the catheter. It would seem then that, if the urine be allowed to accumulate even to a slight extent, whilst a catheter is retained in the bladder, as is necessarily the case where a plugged catheter is made use of, the bladder will by its contraction force some of its contents out by the side of the catheter, and so defeat our object; whereas, if a continuous drain be provided, whereby the bladder can be kept consUntly empty, the ure- thra, even when it has been freely incised, or, as in the third case nar- rated above, when it has been very considerably dilated, may be kept free from the contact of urine. I need hardly dwell further upon the importance of this fact in the after-treatment of operations upon the urinary apparatus. I am san- guine enough to think that the use of the continuous drainage-tube may be the means of materially diminishing the mortality in these cases, by removing the principal barrier to union by first intention of the incisions into the urethral canal. ♦ Before concluding, I am anxious that I shall not be understood to be putting forth a claim to have been the first to have attached an India- rubber tube to the end of a catheter, for the purpose of canying off the urine into a vessel beneath the bed; for I am well aware that several surgeons have anticipated me in that they have made use of the tube for purposes of cleanliness and convenience, but I am not aware that it has ever before been suggested as a principle of treatment in lithotomy and perineal section. And yet, whilst my main object is to