IMPROVED INSTRUMENTS FOR COMPLAINTS IN THE URETHRA AND BLADDER
Year: 1816

page_text: OME, 1,
TO ALL TO WHOM HESE PRESENTS SHALL
SALMON, of Weeburn, in the County of Beds, Surveyor, send greeting.
OBERT
WHEREAS His most Excellent Majesty King George the Third did, by
Ilis Letters Patent under the Great Seal of the United Kingdom of Great
Britain and Ireland, bearing date at Westminster, the Nineteenth day of
August, in the fifty-sixth year of His reign, give and grant unto me, the said
Robert Salmon, my exors, adñiors, and assigns, His especial full power, sole
privilege and authority, that I, the said Robert Salmon, my exors, adiñors,
and assigns, during the term of years therein mentioned, should and lawfully
might make, use, exercise, and vend, within England, Wales, and the Town of
Berwick-upon-Tweed, my Invention of "IMPROVED INSTRUMENTS FOR COMPLAINTS
IN THE URETHRA AND BLADDER;" in which said Letters Patent there is con-
tained a proviso, that if I; the said Robert Salmon, shall not particularly
describe and ascertain the nature of my said Invention, and in what manner
the same is to be performed, by an instrument in writing under my hand
and seal, and cause the same to be inrolled in His Majesty's High Court of
Chancery within two calendar months next and immediately after the date of
the said Letters Patent, that then the said Letters Patent and all liberties and
advantages whatsoever thereby granted, shall utterly cease, determine, and
become void, as in and by the same (relation being thereunto had) may more.
fully and at large appear.
NOW KNOW YE, that in compliance with the said proviso, I, the said
Robert Salmon, do declare that my said Invention of "Improved Instruments

page_text: for Complaints in the Urethra and Bladder" are described and specified in
manner following, reference being had to the Drawings (that is to say) :-
My improved instruments are for the purpose up the urethra and into the
bladder, and discharging its contents, or introducing any medicament thereto,
and are of three several descriptions, as follow:-First, a jointed catheter,
made of metal or other materials; second, a metallic jointed bougie or probe;
third, an improved pliant or resistable bougie, to be covered with wax, cao-
touch, or any other substance. In order to understand the peculiar properties
of these my instruments, and to shew the difference, principle, and superiority
of my Invention over every other, previously to specifying my Invention, it may
be useful to point out the requisites in the instruments for this purpose, the
defects of those in use, and the difference in the action of mine. First, in the
human body it is certain that the passage or canal through the urethra and
into the bladder is not of any regular continued shape, either straight or
circular, but is of compound irregular curvature, so that no unyielding instru-
ment, of any shape whatever, can be passed through the whole length of the
urinary canal and neck of the bladder, without pressing uneaqually in the
passage, or on entering of the bladder and distorting of the natural course;
consequently, altho' an instrument may be of such curvature as to match the
canal, yet considerable art and some force must be exerted to get it to pass into
such situation. Under these considerations it is manifest that the requisites;
any instrument for passing into the bladder, is, that it change its curvature
in its progress through the urethra and neck of the bladder, and not distort,
put out of natural situation, or injure any of the passage which it is only meant
to open and pass. Contrary to this requisite, the present construction of
catheters and probes is to form them as near as can be to the curvature of the
passage, and at the same time of such shape as they may be passed, and these
composed of metal, and unchangeable in their curvature, except where the
partially elastic tin is used, and were these exactly made of the natural bends
of the passage, it would be altogether impossible to pass them; hence it is
manifest a distortion of the line of passage takes place whenever passed, and
unless art be used so to distort and force part of the passage out of its natural
course, the point of any such instrument would not pass into the bladder.
From these considerations and facts in practice the common bougie, when
properly tempered, is found generally the best instrument to pass. But these,
from the uncertainty of the composition with which they are covered, are
liable to objections; if covered with caatouch or elastic gum they, without
difficulty and improper force of their joints in the advanced part of the urethra
or splimeter, will not bend of sufficient sudden curvature. to pass such splimeter
in

page_text: and up into the bladder; and when so passed their elasticity is all the time
exciting an unequal and improper partial force on parts of the passage, they
having always the tendency to become a strait line. To the common bougie
covered with wax, although the best instrument; considerable objections are to
be found. The basis of these is a slip of cloth covered with wax, and rolled
up to the size required. To this construction the following objection arises :—
In rolling up a slip of cloth coated with stiff wax, it becomes a cylinder of
cloth, and in mechanics it is well known that cylinders are most difficult to
bend without breaking or distorting; and in rolling up and pressing such
bougies it commonly happens that they roll atwist, and some of the fine
filaments of the cloth sometimes work to the surface of the bougie, which,
from the moisture of the urethra, is raised, and becomes rough and irritating,
and so frequently does this happen, that seldom is any bougie fit to be passed
more than once. Again, the due pliability of these much depend on the con-
sistency of the wax or composition with which they are covered; if this be too
hard (which by time they always get) they are apt, on use in changing of
their curvature, to crack and bear forcibly on some parts of the passage; if
they are too soft they double in their course, and will not pass at all, or part
of their composition is softened by the oil and warmth of the urethra, and so
rubbed off and left there.
Having thus shewn the defect of these, the principle and advantage of my
Invention may be thus understood. My jointed catheter being formed of a
great number of pieces of metal or other solid substance, will, in its passage,
adjust itself to the course of the canal without the least violence from its point
or sides. My metalic jointed bougie being similarly made (except being solid),
possesses the same advantages, besides which also in the joints of both these
such a quantity of oil or lubricating composition may be placed as to lubricate
the urethra, or even convey a portion of it into the bladder. My improved
pliant bougie will be found to differ from all others, inasmuch as its pliability
and power of resistance is given by the construction of the basis itself, and
does not depend on the wax or composition with which it may be covered.
Also there is no O possibility of any filaments being worked to the side, they are
so equally coated that they may be many times used..
Having thus defined the principles, 1 shall now by Drawings and reference
exemplify the same, not confining myself to any particular size or material, or
number of joints or shape of the pieces of which they may be made.
Fig. 1, jointed metalic flexible catheter. A, tubular stem; B, B, tubular
beads, either spherical or oval, or mixed; C, terminating bead, the neck
thereof flattened; and having an eye to receive the wire or thread, and entering

page_text: into the next bead above it; D, a fine double wire or string passing thro'
the tube and all the beads, and through the eye in the terminating bead,
thereby keeping the whole together; E, cork fitted to the mouth of the
tubular stem, which cork being put in fastens the thread and keeps the beads
together, and this cork having a hole in it will admit the point of a syringe or
other instrument for injecting any liquid into the bladder, or any part of the
urethra, according to the length of the instrument, which may be regulated at
pleasure by the number of pieces introduced on the thread or wire. From
this description it must be manifest that, when the wire or string D is some-
what tightened, all the beads will be brought in contact, and form one flexible
tube to be passed into the bladder, and that when so passed the urine will pass
by the flattened sides of the terminating bead, and along the inside of the beads
and tube, or any liquid may be injected by the same course.
Fig. 2, straight metalic bougie or probe. A, stem, with head to denote
the upper side, either to the sight or touch; B, joint in A, to which the pieces
C, C, C, are jointed and pinned, and the joint B should have play both upwards
and downwards, so as to work as much as ninety degrees of angle; C, C, C,
straight pieces jointed to move upwards but not downwards, so as to form
upwards such curve as may be required; D, terminating joint turned up at
the end, so as more readily to enter the splimeter of the bladder.
Fig. 3, the same in its curved shape as passed through the urethra and into
the bladder. From this view of the straight instrument it must appear that,"
although it will pass, it does not so correctly assume the shape of the curve
and the sudden turning up into the bladder, as if it were made of curvilinear
joints; but if the joints be short the objection to their being straight is not
material.
Fig. 4, curvilinear metalic bougie or probe. A, stem, with head as before;
B, joint in A, having plenty of play, both upwards and downwards, as before;
C, C, C, curvilinear pieces, jointed so as to move upwards but not downwards;
D, terminating joint as before. From a view of this only it may be observed,
that the curvature of the pieces will make them adjust more truly to the
sudden turn into the neck of the bladder.
Fig. 5, basis of pliant and resistable bourgies to be covered with any com-
positions. A, a piece of platted line, commonly called Patent line, bound with
thread or fine twine. This line being platted has no inclination to twist, and.
is in itself perfectly pliant in every direction; but by binding of it with
thread or twine, it becomes resistable, according to the degree of tightness
with which it is bound. After a basis is prepared of any required size, as above.
described, to make the common wax bougie, they are thrown into boiling wax,

page_text: and thoroughly suturated therewith; they are then taken out, and when cold
rolled on a slab or table to make them smooth and straight. After this they
are to be coated with other composition, medicated or not, by dipping them as
in the making of candles, or by laying the composition on hot with a brush;
after which it only requires to be again somewhat rolled on the slab, and
polished up by passing through the hand; and bougies being so constructed
will bear using many times. In this bougie the only parts claimed by me are
its basis, and determining its flexibility and manner of coating it. To any
peculiar coating or covering I make no claim, altho' from this mode of con-
struction a facility arises of medicating certain parts of the bougie to be
applied where it may be wanted.
In witness whereof, I, the said Robert Salmon, have hereunto set my
hand and seal, this Seventeenth day of October, in the year of our
Lord One thousand night hundred and cinch