Volume 1

The standard physician : a new and practical encyclopaedia of medicine and hygiene especially prepared for the household / edited by Sir James Crichton-Browne [and others].

Date:
1908-1909
Catalogue details

Licence: In copyright

Credit: The standard physician : a new and practical encyclopaedia of medicine and hygiene especially prepared for the household / edited by Sir James Crichton-Browne [and others]. Source: Wellcome Collection.

    332/430 (page 306)
    Catheterlsm Chancre THE STANDARD PHYSICIAN 306 CATHETERISM. The procedure of eiu])tying the bladder with the aid of certain instruments (catheters) especially made for this purpose. The}' are made either of metal (German silver, silver, or tin), or of varnished silk- weave, or of red, soft rubber. The catheter is employed either to empty the over-filled bladder (in retention of urine) or for jmrposes of diagnosis and treatment (washing the bladder). Catheterism, as well as the introduction of other instruments into the urethra, should be done only under certain conditions, on which the physician should decide. There is always a danger that bacteria may be introduced into the bladder with the instrument, causing an infection which may give rise to cystitis, or catarrh of the l^adder. It should also be considered that a clumsy and forcible introduction of the catheter may injure the urethra, or cause abrasions of the mucous membrane of the bladder, which may lead to disagreeable consequences. In general, a catheter should be passed only by a physician. If its application is left to the patient, as is sometimes necessary, the following general rules should be borne in mind. Only the soft rubber catheters should be used ; hard instruments are in no way suitable for self-use. Before using the rubber catheter, which is made entirely from raw caoutchouc, it should be carefully examined with reference to its durability. Old cathe- ters that have been in stock for some time become brittle, and it may hapj^en that a fragment may break off, to remain in the urethra or in the bladder. The disinfection of these instruments before and after use is of the greatest importance. Before use they should be placed in a i;iooo solution of silver nitrate or a 1:2000 solution of corrosive sublimate, and then greased with liquid paraffin. After use, the instrument should be cleansed with hot soap-water, and then rinsed and immersed in a 1:1000 solution of corrosive sublimate, after which it should be put into a jar that can be sealed. Before introducing the catheter it is advisable to thoroughly cleanse the glans penis, the prepuce, and the opening of the urethra, by first washing these parts with soap and then rinsing them with a saturated solution ot boric acid. It is of the utmost importance that the hands of the person who introduces the catheter should be thoroughly cleansed and disinfected. See Disinfection. Upon removal of the catheter, the outer opening of the instrument should be closed with a finger, or the end of the soft catheter compressed, in order to prevent the entrance of air into the urethra. If all these directions are borne in mind, self-catheterism, which is so necessary to many patients (for instance, in swelling of the prostate gland of the aged), may do little harm. Carelessness in following out these measures, which is so very apt to become prevalent in frequent practice of self-catheterism, is usually followed by death in from two to three years. CELLULITIS. —A septic inflammation of the cellular tissues. The skin is connected with the underlying organs and tissue-strata by loose, cellular tissue. In consequence of its loose structure an inflammation may easily