Improved Surgical Instrument for Opening or Dilating Morbid Obstructions in the Urethra or other Passages of the Body and Evacuating Liquid or Semi-liquid Matter Obstructed thereby.
Year: 1889

page_text: Date of Application, 10th Oct., 1889
Complete Specification Left, 7th July, 1890-Accepted, 16th Aug., 1890
PROVISIONAL SPECIFICATION.
Improved Surgical Instrument for Opening or Dilating Morbid
Obstructions in the Urethra or other Passages of the Body and
Evacuating Liquid or Semi-liquid Matter Obstructed thereby.
I ALBERT EDWARD DAVIS of 20 Great George Square in the City of Liverpool,
Physician do hereby declare the nature of this invention to be as follows:-
The invention has for its object a surgical instrument designed more especially to
be introduced through the urethra, in order to open or dilate it in cases of stricture or
other like diseases, and to evacuate the contents of the bladder.
Hitherto in cases of stricture or the like, it has sometimes been customary to
first pass a solid and elastic bougie into the urethra in order to open or dilate it,
and when sufficiently dilated to introduce a catheter to evacuate the contents of
the bladder. In many severe cases of stricture it has hitherto been found
impossible to introduce a catheter, and an operation has been necessary which does
not necessarily effect a cure, but only affords temporary relief.
The instrument which I have designed is capable I believe of being successfully
used even in the most severe cases, and will quickly evacuate the urine.
In carrying out my invention I employ a smooth flexible, preferably elastic,
cylinder tapered for about half its length, formed of a convenient size, and pre-
ferably made of the same material hitherto usually used for the purpose. It is
approximately double the length of an ordinary catheter, very fine and slender at one
end but very gradually increasing in diameter towards the middle, after which it is of
the same diameter throughout the remainder of its length. The latter portion is
hollow and constitutes the catheter. The bore communicates with an opening called
the eye in the side, preferably about the middle of the length of the instrument
through which the contents of the bladder are discharged when the instrument has
been introduced into the urethra the necessary distance. The tapered portion is
preferably made solid. By having the eye at some distance from the point the
tapered portion can be made with so small a gradual increase in diameter that the
instrument can be used in those cases of stricture in which it has hitherto been
impossible to pass an ordinary catheter owing to the blunt nature of its operating end,
or the sudden increase in its diameter.
If desired the hollow portion of the instrument may be made firmer or stronger
without seriously injuring its flexibility or pliability by means of a wire stillette, or of
a hollow axis often foil or other metal.
One great advantage of my improved instrument is that by reason of its tapering
to a fine or slender point it may be very readily introduced, even in the most severe
cases of stricture where an ordinary catheter could not be used, or if it could be
employed it would have to be so small as to be of little practical service.
By the use of my instrument a passage can, I believe, in all cases be quickly made
to evacuate the urine, or introduce water or medicinal preparations into the bladder.
I have described my invention more especially for use in connection with stricture:
of the urethra, but it may also be made applicable for introduction into the rectum,
vagina, esophagus or other passages of the body to open or dilate an obstruction or
contraction therein or evacuate liquid or semi-liquid matter obstructed thereby.
Dated this 9th day of October 1889.
WM. P. THOMPSON & Co.,
Of 6, Lord Street, Liverpool, Agents for the Applicant.

page_text: COMPLETE SPECIFICATION.
Improved Surgical Instrument for Opening or Dilating Morbid
Obstructions in the Urethra or other Passages of the Body and
Evacuating Liquid or Semi-liquid Matter Obstructed thereby.
I, ALBERT EDWARD DAVIS of 20 Great George Square in the City of Liverpool,
Physician do hereby declare the nature of this invention and in what manner the
same is to be performed, to be particularly described and ascertained in and by the
following statement :-
The invention has for its object a surgical instrument designed more especially to
be introduced through the urethra in order to open or dilate it in cases of stricture or
other like diseases and to evacuate the contents of the bladder.
Hitherto in cases of stricture or the like occurring in the urethra it has some-
times been customary to first pass a solid and elastic bougie into the urethra in
order to open or dilate it and when sufficiently dilated to introduce a catheter to
evacuate the contents of the bladder. In many severe cases of stricture it has
hitherto been found impossible to introduce a catheter and an operation has been
necessary which does not necessarily effect a cure but only affords temporary relief.
The instrument which I have designed is capable I believe of being successfully
used even in the most severe cases and will quickly evacuate the urine.
The invention may be described by aid of the accompanying drawing in which
Figure 1 shows an instrument full size, part being in section.
Figure 2 is a side view of a part of the instrument, showing the eye thereof.
The instrument which may be said to be a combination of a bougie and a catheter
is about double the length of an ordinary catheter.
The catheter portion A extending from the discharge orifice a to the eye a¹ (which
is by preference placed about midway between the extreme ends of the instrument) is
the same diameter throughout and is hollow as usual in a catheter. It is made of any
convenient size in diameter.
The bougie portion B tapers very gradually from the eye a¹ to the olive point b.
The said portion B is preferably solid and of about the same length as the part A, the
end towards the point being very fine and slender.
In order to render the instrument less liable to fracture at the base of the solid
part B it is preferable to form it with only one eye a¹ instead of two as in an ordinary
catheter, the single eye being sufficient to ensure the proper discharge of the urine
from the bladder into the bore a², of the catheter after the bougie part B, has been
introduced the necessary distance into the urethra.
The instrument may be made of any suitable material or materials but preferably
such as has or have been usually employed in making catheters and bougies. I
find that an instrument made throughout with very flexible gum elastic strengthened
by a coating of flexible textile material, works very well. That part of the textile
coating which surrounds the eye may be woven specially strong or it may be
strengthened in any other desirable manner. The catheter portion may be made of
silver or other suitable metal.
If desired the hollow portion A of the instrument may be made firmer or stronger
without seriously injuring its flexibility by means of a wire stillette or of a hollow
axis of tin foil or other metal. By having the eye at some distance from the point
the tapered portion can be made with so gradual an increase in diameter that the
instrument can be used in those cases of stricture in which it has hitherto been
impossible to pass an ordinary catheter, owing to the blunt nature of its operating
end or the sudden increase of its diameter.
One great advantage of my improved instrument is that by reason of its bougie
portion being solid and tapering to a fine or slender point it may be very readily
introduced even in the most severe cases of stricture where an ordinary catheter could
not be used or if it could be employed it would have to be so small as to be of little
practical service. By the use of my instrument a passage can I believe in all cases

page_text: be quickly made to evacuate the urine or introduce water or medicinal preparations
into the bladder.
I have described my invention more especially for use in connection with stricture
of the urethra, but it may also be made applicable for introduction into the rectum,
vagina, esophagus, or other passages of the body to open or dilate an obstruction or
contraction therein, or evacuate liquid or semi liquid matter obstructed thereby.
Having now particularly described and ascertained the nature of the said
invention and in what manner the same is to be performed, I declare that what I
claim is.
1. A surgical instrument of the kind described consisting of a hollow catheter
portion A of the same diameter throughout and a solid flexible bougie portion B
forming an extension of the part A and tapering very gradually from the catheter
eye to the slender extremity, substantially as and for the purpose described.
2. The improved combined catheter and bougie constructed as a whole substantially
as shown and described.
D
1 TI
WM. P. THOMPSON & Co.,
Agents for the Applicant.