Urinary Catheters and Sounds
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 Catheters are used to drain the bladder via the urinary tract. Sounds
are used to dilate the urinary tract which can be blocked due to infection,
prostate swelling, or trauma. The drawing to the left shows various
situations where a hollow catheter or solid sound is inserted via the
urethra.
Various
forms of urinary tract catheters are shown in pre-Civil War catalogs by
Snowden & Brother and post-Civil War catalogs by Tiemann & Co. and
Gemrig. Frequently we find catheters
are missing for both pocket cases and full surgical cases. Why is
anyone's guess, but the empty formed spaces in a case are testimony to their
being missing. Shown below are pages from Snowden's pre-War catalog in 1860,
Gemrig from the 1870's, and Tiemann's 1880's catalog. The
catheters on this page are silver and rigid, not flexible. This is the type
most often found in large wood cased surgical sets in the lower sections of
the case, under the removable tray.
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To the
best of my knowledge there were no supplier catalogs published during the
Civil War. The post-War catalog evidence I have of this kind of
urinary tract instrument is
from the 1870's, and 1880's catalogs, which may indicate advances in design during
the War, but most likely represents the same type of instruments used during the
Civil War.
Click
on all images to enlarge
Catheters shown in Henry Smith's 1852 book on surgery
Catheters from Snowden & Brother, c. 1860
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Snowden & Brother's pre-War
catalogue shows they were importers of French gum
catheters |
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Catheters, sounds, bogies, from Tiemann & Co., c. 1880's (examples at bottom of
page)
Catheters from Gemrig, c. 1870's
Male
catheters and sounds from Civil War military field sets
Catheters and sounds from a Tiemann Civil War field
set
Catheters and
sounds from a Tiemann Civil War military urology set
Catheter and sounds from a Snowden and Brother Civil War military set
A Tiemann sounds gauge for determination of the diameter
of various sizes of sounds
Below is a collection of Geo. Tiemann
catheters both hard and soft. Both Snowden and Brother, as well as Tiemann imported French soft catheters
and those are included. Some of the soft catheters have ivory tips.
Some of these examples are exactly like those described above in the Tiemann
catalog.
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A page from an 1851 book on urinary
diseases by S. Gross, M.D., which show similar gum catheters.
This information is significant because
we see use of gum catheters during the Civil War, but most are no longer in
the sets because of use or over 125 years, they melt and fuse together.
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Rigid silver catheters for draining the
bladder after dilation with a urethral sound
Silver catheters with loops for attaching a string to
hold them in place
Three examples of catheter use reported during the Civil
War from the History of Surgical and Medical Records
Reasons for rejection of Army
applicants:
(32) Incontinence of urine,
being a disease frequently feigned and of rare occurrence, is not of itself
a cause for exemption. Stone in the bladder, ascertained by the introduction
of the metallic catheter, is a positive disqualification.
Medical cases:
CAMPBELL, HARRISON G., Private of Co.
F, 5th United States Cavalry, aged 25 years, was wounded in action near Louisa
Court House, Virginia, on May 4th, 1863, and fell into the hands of the enemy.
He was exchanged, and sent to Annapolis on the hospital transport State of
Maine, and was admitted to the general hospital at that place on May 17th, with
two suppurating sabre wounds of the scalp, one over the right parietal eminence,
the other behind the left ear. He had headache, with frequent pulse, constipated
bowels, and appeared to be very feeble. He was purged, and then ordered good
diets and." whiskey and quinine freely." On May 20th erysipelas attacked the
left leg, which had received no injury. Tincture of iodine locally and tincture
of the sesquichloride of iron internally were employed to combat this
complication. On May 21st there was epistaxis; the pulse was small, at 110; the
tongue heavily coated. On the 23d there was diarrhoea, which was controlled by
pills of opium and camphor. The next day the pulse had risen to 120, and was
soft. The abdomen was tympanitic. Stimulants were freely given. The catheter was
resorted to, on account of retention of urine, which was scanty and high
colored, and oil of turpentine, in doses of ten drops, thrice daily, was
ordered. On the 28th the erysipelatous inflammation had extended up the back and
over the right leg. The teeth were covered with sordes. Turpentine, with
carbonate of ammonia and whiskey and concentrated nutriment, and tincture of
iodine locally, constituted the treatment. On June 6th, the erysipelas had
extended to the face and throat, and the patient became delirious. He continued
in an unconscious state until June 14th, 1863, when he died. Acting Assistant
Surgeon J. M. Matlock, who reports the case, ascribes the fatal event to
"exhaustion following typhoid erysipelas," and as unconnected with the scalp
wounds, which maintained an healthy appearance to the last.
CASE.--Lieutenant Colonel
Cornelius W. Tolles, chief quartermaster Middle Military Division, was
attacked on the 11th of October, 1864, by a band of guerillas as he was
passing through Newtown, Virginia, on his way to the front. Although he
surrendered without resistance, one of the treacherous party, stepping
behind the Colonel, shot him in the head. The missile, a pistol ball,
penetrated the cranial cavity through the occipital bone at a point midway
between the superior angle and the curved line, three-fourths of an inch to
the left of the median line, making a clean perforation and lodging in the
posterior lobe of the cerebrum one-half inch deep. He was conveyed to
Winchester, and placed under the care of Dr. Emanuel, Acting Staff Surgeon
U.S.A. This officer states that the wound suppurated well, and caused no
pain; the patient's mental faculties remained unimpaired, and his appetite
good, so that a favorable prognosis was granted. On October 22d, the ball
was extracted in small fragments. About the end of October, evacuations of
the faeces and urine began to occur involuntarily; on the 31st, there was an
entire suppression of the urine, as ascertained by the introduction of the
catheter, and the faeces were again discharged involuntarily. On the 4th of
November, the vision and hearing became defective. Delirium ensued, and
death occurred on November 7th, 1864. Upon removing the calvaria, at the
autopsy, the dura mater around the wound was found ecchymosed, and the
cavity in the cerebrum, which was about one-half inch deep, filled with
purulent and offensive pus, and lined with plastic filamentous fibrin. A
fragment of bone, about three-fourths of an inch in diameter, was extracted
from a point just below. The pia mater had suffered morbid changes. A sero-purulent
fluid was found in the inferior and posterior depressions of the lateral
ventricles, and likewise in the fourth ventricle, the lining membrane of
which cavity had undergone softening, as had also the sheaths of the roots
of the seventh, eighth, and ninth pairs of nerves, which were of a greenish
hue; the optic commissure was congested. The substance of the encephalon was
sound throughout. The semi-lunar lobe of the left lateral hemisphere of the
cerebellum was firmly adherent to the tentorium. The case is reported by
Acting Assistant Surgeon W. L. Hammond.
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