Bladder-drainage / by John Chiene.

  • Chiene, John, 1843-1923.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Bladder-drainage / by John Chiene. 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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    a suction power the strength of which depends' on the height of the column of water, and which will draw the urine into the eye of the catheter as it passes drop by drop from the openings of tire ureters into the bladder, and a constant slow current of water will pass along the tube into the bottle. The bottle is allowed to overflow into a basin, which, as it fills, can be emptied by the nurse without any risk of displacing the apparatus. The bladder is kept constantly empty, with the exception of two tiny streams of urine from the ureters to the eye of the catheter. Care must be taken not to have too great a fall, or the suction of a piece of mucous membrane into the eye of the catheter will cause uneasiness and plug the catheter. The height of the hospital bed is generally sufficient, and in some cases even a less height is all that is required. It will be evident to the experimental therapeutist who may desire to study the action of diuretics that by this apparatus much will be learned. The bottle being graduated, the rapidity of action can be easily studied. Since using the instrument on the human subject I have learned that Professor Goltz of Strasbourg has used a similar apparatus in an experimental research requiring an accurate estimate of the exact amount of urine secreted in a given time. In the first case the apparatus did not act perfectly, and on the sixth day the wound became wet with urine. The result wa3 only an improvement. Still, the success was so marked that I tried it in the following year in another case, in which the floor of the urethra was destroyed for an inch and half by injury. The result in this case was a complete success. After the plastic operation the apparatus was applied, and the wound kept perfectly dry until it was soundly healed. Since 1877 this method has been used in a case of recto-urethral fistula with much advantage; in 1879, in four cases of chronic per- sistent perineal fistulas (which had resisted the usual means of treatment). In three of these cases a stricture, in the fourth a perineal abscess, the result of cold, started the condition. In all a permanent cure resulted. In these cases the instrument was kept in continuously for periods varying from a week to a fortnight. It was occasionally removed in order to readjust it. During the time it was removed for cleaning, the patient was instructed not to make his water. I have never found any bad results whatever follow its use. It is also of value in hastening healing, and keeping the patient dry and comfortable during the healing of the wound after external division of a stricture. Let me, however, more particularly direct attention to bladder- drainage in chronic cystitis. It will, I think, take a most important place in the treatment of that troublesome and common affection. The two great symptoms are frequency of micturition (“ irritable bladder ”), and excessive quantities of mucus in the urine (“ catarrh of the bladder ”). The first symptom is at once relieved by the use of the instrument, and in some cases its use even only