Licence: Public Domain Mark
Credit: My recent ureteral work / by Howard A. Kelly. 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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![Catheterization of the Ureters. [SEE PLATES I AND II.] I find so many of my professional friends come to Baltimore for the express purpose of learning to cathe- terize the ureter, that I feel it impor- tant, in response to a number of writ- ten requests also, to briefly describe the method of catheterization as prac- ticed by myself and my assistants at the Johns Hopkins Hospital. I can- not resist the desire to again give a brief historical sketch of the devel- opment of this important addition to the gynaecological field. The medical world has been in a better position to appreciate the im- portance of renal and ureteral path- ology since the work of Rayer and Cruveilhier. Prof. G. Simon was the first to indi- cate a way by which we might collect the urine as it came from the kidney by a catheter introduced into the ureter, thus eliminating vesical con- tamination and differentiating be- tween the two kidneys both as to the quality and quantity of urine. Prof. Simon’s method involved incision of the external meatus, followed by dila- tation of the urethra sufficient to ad- mit the index finger into the bladder, by means of which the ureteral ori- fice was sought out, and under its guidance a slender catheter intro- duced into the bladder and guided up the ureter. The serious objections to this plan are that the catheterization thus be- comes a rather formidable operation, and the stretching of the urethra in women to a sufficient size to admit a finger will certainly be followed by incontinence in a large number of cases. Pawlik, now professor in Prag, obviated all these objections by demonstrating landmarks in the va- gina which serve to locate the ure- ters, and also by greatly improving the catheter. He thus made it pos- sible to catheterize the ureters “free- hand,” by sight alone, without any preparatory operation. Prof. Sanger, of Leipzig, about this](https://iiif.wellcomecollection.org/image/b22461759_0025.jp2/full/800%2C/0/default.jpg)
